The burden of health associated with benign gynecological disorders in low‐resource settings

Black, Kirsten; Fraser, Ian S.

doi:10.1016/j.ijgo.2012.05.002

Cited by 8 publications

(8 citation statements)

References 28 publications

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“…Women workers in India’s vast informal economy typically survive on precarious incomes. As women articulated, gynaecological and menstrual disorders disrupt their work security, similar to findings in other low-income settings ( Harlow and Campbell 2000 ; Patel et al 2006 ; Black and Fraser 2012 ). They, therefore, viewed hysterectomy as both pragmatic treatment and prophylaxis, a permanent solution that secured their future earning capacity.…”

Section: Discussionsupporting

confidence: 68%

Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India

Desai

Campbell

Sinha

et al. 2016

Health Policy Plan.

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Hysterectomy is a leading reason for use of health insurance amongst low-income women in India, but there are limited population-level data available to inform policy. This paper reports on the findings of a mixed-methods study to estimate incidence and identify predictors of hysterectomy in a low-income setting in Gujarat, India. The estimated incidence of hysterectomy, 20.7/1000 woman- years (95% CI: 14.0, 30.8), was considerably higher than reported from other countries, at a relatively low mean age of 36 years. There was strong evidence that among women of reproductive age, those with lower income and at least two children underwent hysterectomy at higher rates. Nearly two-thirds of women undergoing hysterectomy utilized private hospitals, while the remainder used government or other non-profit facilities. Qualitative research suggested that weak sexual and reproductive health services, a widespread perception that the post-reproductive uterus is dispensable and lack of knowledge of side effects have resulted in the normalization of hysterectomy. Hysterectomy appears to be promoted as a first or second-line treatment for menstrual and gynaecological disorders that are actually amenable to less invasive procedures. Most women sought at least two medical opinions prior to hysterectomy, but both public and private providers lacked equipment, skills and motivation to offer alternatives. Profit and training benefits also appeared to play a role in some providers’ behaviour. Although women with insecure employment underwent the procedure knowing the financial and physical implications of undergoing a major surgery, the future health and work security afforded by hysterectomy appeared to them to outweigh risks. Findings suggest that sterilization may be associated with an increased risk of hysterectomy, potentially through biological or attitudinal links. Health policy interventions require improved access to sexual and reproductive health services and health education, along with surveillance and medical audits to promote high-quality choices for women through the life cycle.

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Section: Discussionsupporting

confidence: 68%

Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India

Desai

Campbell

Sinha

et al. 2016

Health Policy Plan.

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“…As DAP acarretam altos custos tanto para o indivíduo quanto para o sistema de saúde 9 , e estão relacionadas a pior qualidade de vida (QV) relacionada à saúde e menor produtividade laborativa 10 . Embora o seu impacto negativo sobre a QV pareça evidente, a utilização de questionários capazes de quantificá-lo pode permitir a identificação dos sintomas mais graves e os domínios mais afetados, assim como a avaliação dos resultados de terapêuticas clínicas e cirúrgicas 11 .…”

Section: Introductionunclassified

Prevalência de incontinências anal e dupla em idosas e impacto na qualidade de vida

Faria¹,

Benayon

Ferreira

2018

ACS

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ResumoIntrodução: A prevalência das incontinências anal e urinária que são mais comuns em mulheres, aumenta com a idade. Tais disfunções podem ser encontradas isoladamente ou em associação (incontinência dupla) e podem provocar grande impacto na qualidade de vida. Objetivos: Avaliar a prevalência das incontinências anal e dupla e o impacto dessas condições sobre a qualidade de vida de mulheres idosas da comunidade. As variáveis foram estudadas de maneira descritiva, por meio do cálculo de frequências absolutas e relativas e, no caso da variável idade e dos escores de qualidade de vida, por meio do cálculo da média e desvio-padrão. Resultados: Participaram da pesquisa 66 mulheres, com média de idade de 69,6±7,2 anos. A prevalência de incontinência anal foi de 28,8% (n=19), e a prevalência de incontinência dupla foi de 18,1% (n=12). Pacientes com incontinência anal isolada e dupla apresentaram impacto negativo na qualidade de vida, conforme indicado pelos escores dos domínios avaliados. Conclusão: A prevalência de incontinência anal foi mais elevada do que a prevalência de incontinência fecal isolada ou de incontinência anal encontrada em outras populações. O mesmo foi observado em relação à prevalência de incontinência dupla. Houve impacto negativo de ambas as condições em todos os domínios de qualidade de vida avaliados. Descritores: Incontinência fecal; Incontinência urinária; Qualidade de vida; Saúde do idoso AbstractIntroduction: The prevalence of anal and urinary incontinence is more frequent in women, and it increases with age. Such dysfunctions may be found alone or in combination (double incontinence), and they may have a major impact on quality of life. Objectives: Evaluate the prevalence of anal and double incontinence, as well as the impact these conditions cause on the quality of life of elderly women residents in a community. Patients and Methods:We carried out an observational descriptive study involving women aged 60 and over who sought the Primary Health Care Unit for vaccination. For the urinary and anal incontinence screening, Brazilian versions of the International Consultation on Incontinence Questionnaire -Short Form and the Anal Incontinence Index were used. Women who presented scores different from zero in both questionnaires were diagnosed with double incontinence. The evaluation on the impact of anal incontinence on quality of life was done through the Brazilian version of Fecal Incontinence Quality of Life Questionnaire. We used descriptive statistics to calculate relative and absolute frequencies. Age and Quality of life domain scores were expressed using mean and standard deviation. Results: Sixty-six women were included in the study. Mean age was 69.6±7.2 years. The prevalence of Anal Incontinence was 28.8% (n=19) and the prevalence of double incontinence was 18.1% (n=12). Patients with isolated and double anal incontinence had a negative impact on quality of life, as indicated by the scores of the domains evaluated. Conclusions: The prevalence of anal incontinence was higher than the...

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“…The structural realities of girls and women’s lives in many LMICs create a gap in information through, for example, minimum media exposure to health messages, the lack of accessible health clinics that are focused on reproductive health 43 ; the low rates of secondary and tertiary education persisting in many countries, 44 45 the lower access to internet and media that girls and women have in comparison to boys and men 46 47 ; and health clinic staff who may be insufficiently trained to conduct differential diagnosis or to be adequately supportive of questions about vaginal bleeding. 48 Girls and women’s access to services may also differ depending on their age, marital status, geographical location and economic status, along with the prevailing gendered norms in the household influencing the seeking of care. 49 50 …”

Section: Introductionmentioning

confidence: 99%

Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries

et al. 2017

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Girls and women experience numerous types of vaginal bleeding. These include healthy reproductive processes, such as menstruation and bleeding after childbirth, but also bleeding related to health conditions, such as fibroids or cancer. In most societies, the management of menstruation is handled covertly, something girls are often instructed about at menarche. The management of other vaginal bleeding is often similarly discreet, although behaviours are not well documented. In many societies, cultural taboos frequently hinder open discussion around vaginal bleeding, restricting information and early access to healthcare. Additionally, the limited availability of clean, accessible water and sanitation facilities in many low and middle-income countries augments the challenges girls and women face in conducting daily activities while managing vaginal bleeding, including participating in school or work, going to the market or fetching water. This paper aims to highlight the key vaginal bleeding experiences throughout a woman’s life course and the intersection of these bleeding experiences with their access to adequate water and sanitation facilities, information and education sources, and supplies. The aim is to address the silence around girls and women’s vaginal bleeding and their related social, physical and clinical management needs across the life course; and highlight critical gaps that require attention in research, practice and policy around this neglected topic of health and gender equality.

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The burden of health associated with benign gynecological disorders in low‐resource settings

Cited by 8 publications

References 28 publications

Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India

Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India

Prevalência de incontinências anal e dupla em idosas e impacto na qualidade de vida

Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries

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