Strategies for the prevention and treatment of reproductive tract infections among women in Vietnam

Abstract

This paper presents selected findings from a larger study on reproductive tract infections (RTIs) among women seeking abortion in Northern Vietnam. In particular it focuses on women's experience of RTIs within the context of their perceptions of female physiology and what women do to prevent and treat RTIs. The approach used was a combination of the quantitative and the qualitative: 748 structured interviews were undertaken before, and 701 after, abortion; and in-depth interviews were carried out with 20 women and 20 healthcare providers. Both healthcare providers and women believed that RTIs are an essential and normal part of womanhood. Reproductive tract infections were associated with laziness, being unclean and hesitance in using health facilities for help with gynecological problems. Women used various forms of self-treatment, including some that may be medically harmful. Women's preventive and treatment strategies were often supported and sometimes even promoted by healthcare providers. We assess women's strategies for RTI prevention and treatment in the context of the current Vietnamese health system and from a gender perspective. These strategies highlight inadequacies in the public healthcare system, while also pointing to important cultural paradoxes in the understanding of womanhood in contemporary Vietnam.

Reproductive Tract Infections in Rural Vietnam, Women's Knowledge, and Health-Seeking Behavior: A Cross-Sectional Study

“…Being "clean" in order to be ready if their husbands would make sexual demands has been shown as an essential aspect to Vietnamese women's daily life (Huong et al, 2008). Furthermore, vaginal washing/douching is known to be used for preventive and treatment purposes, an action that rather increases the risk of RTI (Huong et al, 2008;Lan et al, 2008a). Again, these findings-as well as ours-could apply to other similar settings in other parts of the world.…”

“…Women are often blamed for the transmission of RTI (Meyer-Weitz, Reddy, Van den Borne, Kok, & Pietersen, 2000). Being "clean" in order to be ready if their husbands would make sexual demands has been shown as an essential aspect to Vietnamese women's daily life (Huong et al, 2008). Furthermore, vaginal washing/douching is known to be used for preventive and treatment purposes, an action that rather increases the risk of RTI (Huong et al, 2008;Lan et al, 2008a).…”

“…There is also a strong tradition to ask female friends about these problems instead of Downloaded by [New York University] at 07:45 08 June 2015 seeking health care (Binh et al, 2010). Additionally, women in this context are known to normalize their vaginal problems and regard them as normal parts of their lives (Huong et al, 2008).…”

“…It has thus been shown that many women ignore symptoms of RTI or self-treat (Go, Quan, Zenilman, Moulton, & Celentano, 2002). Selftreatment involves, for instance, external and internal genital washing with homemade remedies or commercial products (Huong, Gammeltoft, & Rasch, 2008) consequently leading to a worsening of the nature of the disease (Hawkes et al, 1999), a delay in seeking health care (Binh, et al, 2010), or both. Women's health-seeking behavior is further influenced by their perception of the severity of the disease, lack of time, trust in the health care system, fear of stigma related to a possible diagnosis as well as distance of health care from their homes (Go et al, 2002;Gorbach, Hoa, Eng, & Tsui, 1997;Prasad et al, 2005;Rabiu et al, 2010).…”

Enterococcus and Streptococcusspp. associated with chronic and self-medicated urinary tract infections in Vietnam

“…This is partly because UTIs are most often not reportable diseases and self medication is common, so many infections are treated by patients or pharmacists alone [10]. It has previously been described that Vietnamese women use various forms of self-treatment to prevent and cure reproductive tract infections which may be potentially harmful and may favor opportunistic infections [11]. …”