A Study on Prevalence of Gynecological Problem in Gilgit

A Study on Prevalence of Gynecological Problem in Gilgit.: 

By Shabina Jabeen Department of Biological Sciences Supervised by: Dr. Nazir Ahmed Lone A Study on Prevalence of Gynecological Problem in Gilgit.

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Background: 

Background The rapid occurrence of gynecological problems in my surrounding made me curious to know about these issues. I came across women from different backgrounds with similar issues. The lives of women with such disorders is worse. The health of whole society depends on their well being.

con.. : 

con.. There are many illness, diseases and disorders faced by them in their life time and on the other side the religious, cultural, economic and social restrictions prevent them to express their sufferings to a doctor. In view of the above facts and having the knowledge that there is a scarce data available on gynecological morbidities in the region a cross sectional study was conducted in Gilgit.

Aims and objectives: 

Aims and objectives To assess the different gynecological problems of women in this region. To know about the attitude, knowledge, perception and practice of women regarding their diseases.

Con…: 

Con… To evaluate the prevalence of early marriages and incidence of gynecological problems. To see the quality of life and overall health of the women in this region.

Research Methodologies : 

Research Methodologies Direct method for primary data A cross sectional study was conducted between 14 Feb 2011 to 8 th March 2011. Data was collected through interviews from two different sources: 1. Women interviewed at hospitals 2. House to house interviews,

Surveys : 

Surveys (1).Two main hospitals of Gilgit namely District Head Quarter Hospital (DHQ), and Central Military Hospital (CMH) were chosen keeping in view the availability of patients in numbers from every corner of the region. (2) A population-based health interviews in Diamer Colony. Questionnaires were filled after verbal consent.

Questionnaire : 

Questionnaire Women of reproductive age both married and unmarried were interviewed directly after their permission. The medical reports and history of the suffering women at hospital were seen after diagnosis by the gynecologist. On the other hand women at homes were also interviewed checking their medical documents of few who had been to hospital.

Sample size: 

Sample size The sample size selected was 175. It was divided into two groups. Group A included the women with gynecological problems interviewed at hospitals135 (84.4%) Group B comprised list of women interviewed at homes 40 (25%) with complain 25 (15.6%) and without any complains15 (9.4%).

Main Diagnosis: 

Main Diagnosis Disfunctional Uterine Bleeding;DUB (17.4%), Mixes Vaginitis (17.4%), Infertility (13.9%), Urinary Tract Infections;UTI (10.4%). Anemia (8.3%), Threatened pregnancies (6.3%), Cysts (5.6%),

Other diagnosis: 

Other diagnosis Fibroids (4.9%), Pelvic Inflammatory Diseases;PID (4.2%), Menopausal bleeding (4.2%), Prolapse (2.8%), Pypertension (2.1%), Rectovaginal fistula (0.7%) Retroverted uterus (0.7%).

Prevalence of early marriages : 

Prevalence of early marriages Age at marriage No of women,% 8-11 2 (1.4) 12-15 49 (34.0) 16-19 53 (36.8) 20-23 33 (22.9) 24-27 6 (4.2) 28-31 1 (0.7) Total 144

Age at the time of marriage: 

Age at the time of marriage

Early marriages: 

Early marriages Early teenage and late teen age marriages are of the highest ratio (70.8%) among the patients (34% and 36.8% respectively). The other high percentage of marriage was in the early twenties (22.9%). The number of women married at late 20s was quite low in this population, strongly suggesting that they suffer lesser as compared to those who got married at early ages.

  Professional status of patients. : 

Professional status of patients. Profession No of women, (%) House wife 117 (73.1) Student 24 (15) Teacher 9 (5.6) Jobless 7 (4.3) Tailor 2 (1.2) Employee 1 (0.6) Total 160

Patients by profession : 

Patients by profession

Con…: 

Con… The number of housewives was highest (73.1%) in this study. This shows that the most vulnerable to diseases are those women who are at home and without any job or any economic income.

Perception of women about the cause of diseases.: 

Perception of women about the cause of diseases . Perceptive reason No of women,% I don’t know 41 (25.6) contraception 26 (16.3) Heavy domestic work 16 (10) Stress 12 (7.5) Weakness 10 (6.3) Sex habits 9 (5.6) No care in deliveries 9 (5.6) Nutritional deficiencies 8 (5.0)

Cont.. : 

Cont.. Miscarriages 6 (3.8) DNC 5 (3.1) Poor hygiene 4 (1.9) God ‘s will 4 (2.5) Jumps 3 (1.9) Its natural 3 (1.9) Frequent child birth 2 (1.3) Others 2 (1.3) Total 160

Perceptions of cause of disease: 

Perceptions of cause of disease According to the patients the reason for their ill health is given in the above data. There were more than one reason per women but the most appropriate reason was chosen. 25% patients had no any perception about cause of their diseases. Majority (16.3%) of women believed contraception was the cause of their diseases.

Total time for the problem: 

Total time for the problem Time span (years) No of women, (%) 0-1 94 (58.7) 2-3 32 (20.13) 4-5 11 (6.92) 6-7 8 (5.03) 8-9 4 (2.52) 10-11 3 (1.9) 12-13 3 (1.9) 14-15 3 (1.9) 16 < 2 (1.2) Total 160

Explanation : 

Explanation This table shows the time span for their problem. Majority reported that they had the problem from several weeks to 12 months (58.7%). Patients with 2 to 3 years for their problem were 20%. The 5% of the total comprised of patients who had 4 or 5 years for their suffering. 2.5% (8-9 yrs). 1.9% had the problem for (10-11).1.9% (12-13yrs), 1.9% (14-15yrs), 1.2% (16yrs and above).

Treatment Time: 

Treatment Time Time No of women, (%) 0-1 86(53.7) 2-3 12 (7.5) 4-5 6 (3.7) 6-7 3 (1.9) 8-9 2 (1.2) 10-11 3 (1.9)) Total women treated 112 (70) Never been to hospital 16 (10) Fresh patients 32 (20) Total 160

Explanation : 

Explanation This table gives the time for their treatment. 70% of the total was using drugs and treatments. 20% were fresh patients. 10% had never been to hospitals. Patients who had used medicines for several days, weeks or 12 months were (53.7%) of the whole sample. 7.5% of patients used drugs for 2 to 3 years. 3.7% reported to have used it for 4 to 5 years.

Con..: 

Con.. For 6 to 7 years (1.9%). 8 to 9 years (1.2%). The longest time span 10 to 11 years were 1.9%. Graphic representation of the above two tables shows that patients have started treatment late.

Time span for problem and treatment time: 

Time span for problem and treatment time

District wise list of Patients: 

District wise list of Patients District No of Women,% Gilgit 94 (58.7) Ghizer 26 (16.25) Hunza Nagar 20 (12.5) Astor 10 (6.25) Diamir 10 (6.25) Total 160

Districts : 

Districts

Explanations : 

Explanations The above table shows the district wise number and percentage of patients. The highest number of patients was from Gilgit (58.7%) the fact that the study was conducted In the same district and the number of patients frequent the nearby hospitals. From Ghizer (16.25%) patients were present. Hunza Nagar (12.5%) Astore (6.2%) and Diamir (6.2%).

Cont..: 

Cont.. The percentage and ratios does not show the prevalence of gynecological problems more in some region or less in another. It mainly indicates the availability of patients at the two hospitals (DHQ, CMH) and targeted area (DC). The preference of getting checked at hospitals in Gilgit is shown here region wise. Others might prefer to go to the hospitals of their choice or even don’t get checked at all.

Age and marital status of patients: 

Age and marital status of patients Age No.of women,(%) Married, (%) Unmarried, (%) 13-19 16 (10) 8 (5.5) 8 (50) 20-26 55 (34.37) 47 (32.6) 8 (50) 27-33 38 (23.75 38 (26.03) 0 34-40 31(19.37) 31 (21.23) 0 41-47 9 (5.62) 9 (6.16) 0 48-54 6 (3.7) 6 (4.11) 0 55-61 5 (3.1) 5 (3.42) 0 Total 160 (100%) 144 (90 %) 16 (10%)

Married and unmarried women: 

Married and unmarried women

Explanations : 

Explanations The above table categorizes patients by age and marital status. The highest number of women suffered were in their 20s and 30s. The fact that prevalence of gynecological problems of women is highest at their reproductive age (73.5%). Which is 4 times the no of women at their early reproductive (teenage) or post reproductive age (22.4%).

Con..: 

Con.. (10% of the population comprised of teenagers. Half of them were unmarried and half unmarried); a ratio of 1:1 indicates that both married and unmarried suffered equally. 144 (90%) women out of 160 were married; just 16(10%) were unmarried. No unmarried patient was in their late 20s or above this age. Average age was 30 years.

Qualification of patients: 

Qualification of patients Qualification No of women,% Illiterate 85 (53.1) Nursery 10 (6.2) Primary 6 (3.7)) Middle 10 (6.2) Secondary 17 (10.6) Higher secondary 12 (7.5) Bachelors 11 (6.8) Masters 9 (5.6) Total 160

Qualifications: 

Qualifications

Explanations : 

Explanations This table gives the statistics that most of the patients (53.1%) were illiterate. This is an obvious sign that their knowledge about reproductive health is scarce and the concern for their health is at low priority as compared to educated women. It is obvious from the above table that patients with higher education come up with lesser gynecological problems. Another figure lesser then this was 10%, the value indicates the number of women who are matriculated.

Con..: 

Con.. Most of the people got married after 10 th class or ended up with formal education due to financial problems believing that this level is enough. The (10%) at nursery level includes those patients who have got the basic education of reading and writing. Some patients were currently doing their college level education and others had ceased due to the above reasons. However some bachelor degree holders were also doing job. The 5.6% includes the patients with masters degree and most of them were without jobless.

Reasons for not seeking health care: 

Reasons for not seeking health care Reasons for not seeking hospital No of women, (%) Financial burden 26 (16.2) Over looked the problem 12 (7.5) Family disapproval 7 (4.4) Time problem 6 (3.7) No trust on drugs 6 (3.7) Was afraid to tell 5 (3.1) Hospital is far 5 (3.1)

Con..: 

Con.. No privacy 5 (3.1) Waited to heal on its own 4 (2.5) Local medicines 2 (1.2) Doctors not good 1 (0.6) No idea of hospital 1 (0.6) Others 1 (0.6) Total 81 (50.6) Gone to hospital on time 79 (49.4) Total 160

Explanations: 

Explanations The most common reason found was financial problem (16.2%). 7.5% reported that they have ignored their ailment as they considered it normal for women. 4.4% faced family disapproval. 3.7% said they could not adjust time. Another 3.7% had no trust on drugs after using it, so they remained at home. 3.1% patients were reluctant to share their personal problem with a gynecologist as they considered as a matter of privacy.

Con..: 

Con.. Another 3.1% were afraid to tell their problem considering it a matter of self respect. An equal number 3.1% of the patients lived far from the hospital so could not manage coming sooner. 2.5% patients believed that their ailment will soon be over without any treatment. Only 1.2% did not come to hospital on time because they were using local medicines. The other reasons were least common (doctors are not well, 0.6%. no idea of hospital 0.6%). The patients who have been to hospitals on time and those who have gone late when their conditions worsen were nearly equal (49.4% and 50.6%) respectively.

Medicines work or not: 

Medicines work or not Are you satisfied with the treatment No of women, (%) No 66 (41.2) Yes 42 (25.2) Partly 4 (2.5) New patient 32 (20) No treatment 16 (10) Total 160

Explanations: 

Explanations The patients who have been visiting different hospitals for more than one week and were using medicines asked if they were getting any benefit from it or not. Majority (66%) answered in negation. Whereas (42%) reported that their condition has improved after using the medicines.

Con..: 

Con.. Though some of the patients were not sure if they had used medicine on time or regularly as prescribed by the doctor. 2.5% were partly satisfied. 20% consisted of patients who were at hospital for the first time and had not used medicines yet. There were patients (10%) who have not been to hospital at all.

Usage of local medicines: 

Usage of local medicines Usage of local medicines No of women, (%) No 143 (89.3) Yes 17 (10.6) Total 160 This table shows that majority (89.3%) of women interviewed in this study did not use local medicines like herbs, or get any treatments from local midwives or others whereas 10.6% reported that they have used. The ratio among these patients in hospitals is less because they prefer hospitals to local medicines, but people at far flung areas might possibly prefer their own local medicines. This table shows that majority (89.3%) of women interviewed in this study did not use local medicines like herbs, or get any treatments from local midwives or others whereas 10.6% reported that they have used. The ratio among these patients in hospitals is less because they prefer hospitals to local medicines, but people at far flung areas might possibly prefer their own local medicines.

Explanations: 

Explanations This table shows that majority (89.3%) of women interviewed in this study did not use local medicines like herbs, or get any treatments from local midwives or others whereas 10.6% reported that they have used. The ratio among these patients in hospitals is less because they prefer hospitals to local medicines, but people at far flung areas might possibly prefer their own local medicines.

RECCOMENDATIONS: 

RECCOMENDATIONS Mass awareness programs about reproductive health are strongly needed in our society. Women who use contraceptive pills etc. usually don’t know details about it. There must be a proper lab system in each hospital in Gilgit , so that tests must be performed here and reports made quicker and less costly. Early marriages is regarded as violation of human rights, it limits the chances for girls to continue studies in most of the case Proper legislation in this regard is necessary.

Con…: 

Con… The trend of adoption of their relatives’ kid must be encouraged because at one end the people reproduce numbers of kids and could not give them a quality life and on the other end people remain childless whole their lives. Men and women must be given chances to get involved in other activities rather than producing 12 kids. Vocational centers and technical centers must be introduced.

Con..: 

Con.. Students must be encouraged to do research in this area of study or on related topics, as research is strongly required to find out the linkages between socioeconomic conditions and health status of people in this region.

Summary : 

Summary The average age of patients was 30 years. Dysfunctional Uterine bleeding (17.4%), and Vaginitis (17.4%) of different types were the most common problems in this study. Retroverted uterus (0.7%) and Rectovaginal fistula (0.7%) were least common. Lower abdominal pain was mostly reported complain (43.1%).

Summary : 

Summary Average no of kids was 5 among the married women having kids. The average age at marriage among the married women was 17 years. The number of housewives was highest (73.1%). Most of the patients (53.1%) were illiterate. Majority of women believed contraception (16.3%) was the cause of their ill health. 10% of patients had been no where for their treatment.

THANK YOU: 

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