BACKGROUND OF THE STUDY

Reproductive morbidity is a broad concept that encompasses health problems related to reproductive organs and functions, including and outside of childbearing.

Reproductive morbidity can be broadly categorized into three subgroups: obstetric morbidity, gynecological morbidity and contraceptive morbidity. Obstetric morbidity refers to ill health in relation to pregnancy and childbirth. Gynecological morbidity includes health problems outside pregnancy such as RTIs, menstrual problems, cervical ectopic, infertility, cancers, prolepses and problems related to intercourse. Contraceptive morbidity includes conditions, which result from efforts to limit fertility, whether they are traditional or modern methods. Reproductive morbidity in general, is an outcome of not just biological factors but of women’s poverty, powerlessness and lack of control over resources as well. Malnutrition, infection, early and repeated childbearing and high fertility also play an important role in poor maternal health conditions in India.

According to the World Bank, about one third of the total disease burden among women aged 15 to 44 years in the developing countries is linked to health problems associated with pregnancy, childbirth, abortion, HIV, menstrual problems, breast problems and reproductive tract infections and among the diseases for which cost-effective interventions exist, reproductive health problems account for the majority of the disease burden in women of this age group (World Bank, 1993)

Prevalence of menstrual problems by specific symptoms among rural women in Maharashtra, revealed that, one fourth of the women suffering from any menstrual problem nearly half of them are suffering from painful periods (45 percent) followed by scanty bleeding (39 percent) delayed period (29 percent) and excessive bleeding (14 percent).

Based on the self-reported symptoms of gynecological problems among 3600 recent mothers in Karnataka state, Bhatia and Cleland (1995) found that approximately one third of the women reported symptoms suggestive of at least one kind of gynecological morbidity; approximately one-sixth of the women reported white or coloured vaginal discharge associated with lower reproductive tract infections and another five percent reported lower abdominal pain or vaginal discharge with fever indicative of acute pelvic inflammatory disease. Other commonly reported symptoms by about one fourth of respondents were excessive tiredness and a feeling of breathlessness during normal household activities, possibly indicative of anemia. Several other analytical researches in urban and rural areas have provided insights into women’s perceptions of their reproductive morbidities and more importantly their treatment seeking behaviour for the same. These studies have revealed the almost apathetic attitude that women have in seeking treatment for their health problems (Gittlesohn, et al., 1994; Kapadia et al., 1997). Women resorted to treatment seeking only when it caused great physical discomfort or when it affected their work performance. Moreover, the treatment seeking was better when women received advice and support from significant others especially husband, mother or neighbour (Kapadia et al., 1997)

A synthesis of results from seven community studies based on women’s self-reported histories as well as clinical examinations in a range of geographical and cultural setting within India reiterates the poor reproductive health status of women (Latha et al., 1997; Koenig et al., 1998). The levels of gynaecological morbidity were found to be unacceptably high at all sites with 55 to 84 percent of women reporting one or more such problems. Among the various problems reported, menstrual disorders ranged from 33 to 65 percent, excessive white discharge accounted for 13 to 57 percent while lower abdominal pain and lower backache ranged from 9 to 21 percent and 5 to 39 percent respectively. Clinical diagnosed conditions also revealed wide variations. The prevalence of vaginitis ranged from 4 to 62 percent, cervicitis from 8 to 48 percent, cervical erosion from 2 to 46 percent and pelvic inflammatory diseases ranged from 1 to 24 percent. The percentage of women with one or more clinically diagnosed conditions ranged from 26 percent to as high as 70 percent.

Cervical cancer is the single largest killer of middle-aged women in India. The incidence of cervical cancer per 100, 000 Indian women of all ages varied between 30.0 and 44.9 (WHO, 2010). India bears about one fifth of the world’s burden of cervical cancer (Shanta, 2003). More than 100,000 new cases are detected in India per year and the disease causes almost 20 percent of all female deaths in India (Shanta, 2003). About 75-80 % of the cases are reported in advanced stage (National Cancer Registry Programme, 2006). The menace of cervical cancer is still haunting India in-spite of this being a preventable disease.

Cancer of cervix remains a major public health problem for India. We here assessed knowledge levels of female college students about cervical cancer, its risk factors, the human papillomavirus (HPV) etiologic agent and Pap (Papanicolaou) smear testing for screening. We conducted a questionnaire survey of the students (N=630), aged 17 to 24 years, in Kolkata, India. Only 20% correctly identified cervix cancer as the most prevalent female cancer in India, while 43% were aware of the ages of occurrence. Though 41% thought sexual activity to be associated with cervical cancer, its risk factors, like, ‘smoking’, ‘having multiple sex partners’, ‘cervical infections’, ‘early onset of sexual intercourse’, ‘multiple parity’ were recognized by 29%, 3%, 4%, 13% and 15%, respectively.

Generally women with self-reported symptoms of reproductive morbidity do not seek treatment due to existing taboos and inhibitions regarding sexual and reproductive health. They hesitate to discuss about the reproductive problem especially, due to shame and embarrassment (Bang et. al., 1989 and Oomen, 2000). Even if they seek treatment, a majority of women seek health care from quacks or unqualified for their health.

STATEMENT OF THE PROBLEM:

A descriptive study to identify the reproductive health problems among women working in selected weaving mill, Namakkal District

OBJECTIVES:

1. To identify the reproductive health problems among women

2. To find out the association between reproductive health problems score among women with their selected demographic variables.

ASSUMPTION:

The study assume that,

§ Reproductive health problems are common among women.

§ Reproductive health problems are a major cause of infertility.

§ Women are lacking of knowledge regarding reproductive health problems and its management

DELIMITATIONS:

The study is limited to,

1. Reproductive health problems

2. Women working in weaving mill, Namakkal District.

MATERIALS AND METHODS:

Research approach:

A quantitative research approach was selected to collect the data from the women to study the reproductive health problems.

Research design:

A cross sectional descriptive research design was used

Research setting:

The study was conducted in selected weaving mill, Namakkal District.

Population:

The population for the present study was the women working in weaving mill.

Sample:

The sample consisted of 75 women working in selected weaving mill, Namakkal District.

Sampling technique:

Consecutive sampling technique was used to select the sample for the study.

Development of tool:

A baseline Proforma and checklist on rreproductive health problems was prepared with the help of review of literature, personal experience and discussion with experts.

Description of the tool:

Section A: Baseline Proforma of the samples

Section B: Checklist on reproductive health problems

Section A: Baseline Proforma:

It contained items for obtaining information regarding age, education, age at menarche, duration of cycle, type of flow, problems during menstruation, family history of reproductive health problems, and source of information

Section B: Checklist on reproductive health problems:

It consisted of 8 items such as menstrual problems, anaemia, vaginal infection/discharge, breast infections, breast cancer, cervical cancer, frequent abortion, reproductive tract infection and infertility.

Plan for data analysis:

The data were analysed by using both descriptive and inferential statistics

· Baseline proforma of the samples were described by frequency and percentage distribution

· Mean percentage was used to identify the reproductive health problems among women.

· Chi square test was used to find out the relationship between selected variables of women with their reproductive health problems.

RESULTS:

Section A:

37% of the women were in the age group of 29 -38 years and 40% of them had no formal education. However 64% of the women attained menarche at the age of 10 -15 years, 70% of women were in 25 -30 days cycle. Most (77%) of women had regular flow, 56 % of them had problem during menstruation, 69% of women were with the family history of reproductive health problems and 40 % of women had source of information from health care personnel.

Section B: The findings revealed that the reproductive health problems,

S.NO	Reproductive health problems	Percentage (%)
1	Menstrual problems	30
2	Anaemia	16
3	Breast infections	16
4	Vaginal infections/ discharge	13
5	Reproductive tract infection	8
6	Infertility	8
7	Frequency of abortion	8
8	Breast cancer	3
9	Cervical cancer	3

Section D:

There was a no significant association between the reproductive health problems scores and variables like age, age at menarche, duration of cycle, type of flow, problems during menstruation, family history of reproductive health problems, and source of information. But there was a significant association with reproductive health problems among women and their educational status, ( χ²= 4.51 , p > 0.05)

CONCLUSION:

· The findings of mean and SD of samples based on reproductive health problem assessment check list revealed that 1.84 and 0.93.

· The mean percentage was 10.2

· The commonest reproductive health problems are menstrual problem, anaemia, breast infection and vaginal infection

· There was a significant association between the reproductive health problem scores and their variable of education.

· There was no significant association between the reproductive health problem scores and variables like age, age at menarche, duration of cycle, type of flow, problems during menstruation, family history of reproductive health problems, and source of information

RECOMMENDATIONS:

1. A study can be conducted with large samples to generalize the findings.

2. A comparative study can be done between urban and rural women.

3. SIM can be developed based on the learning needs of the women regarding reproductive health problems and its self-care management.

4. Intervention study can be conducted to know the effect of various treatment methods in reducing reproductive health problems.

REFERENCE:

1. Barua, A and Kurtz, Cathleen (2001): “Reproductive health seeking by married adolescentgirls in Maharashtra, India”, Reproductive Health Matters, Vol. 9(17)

2. Oomman, Nandini (2000): “A decade of research on Reproductive Tract Infections and other Gynecological Morbidity in India: What we know and what we don’t know in Ramasubban and Jejeebhoy (eds.) Women’s Reproductive Health in India, New Delhi: Rawat Publication.

3. A Saha, A Nag Chaudhury, Awareness of Cervical Cancer Among Female Students of Premier Colleges in Kolkata, India. Asian Pacific Journal of Cancer Prevention, Vol 11, 2010

4. Das &Urvi shah. Understanding women’s reproductive health needs in the rural areas of Gujarat, 2009

5. World Health Organization (WHO) (2010). Human papillomavirus infection and cervical cancer. Available at: www.who.int/vaccine_research/diseases/hpv. Accessed February 21.

6. Shanta V. Perspectives in cervical cancer prevention in India, (2003). The International Network for Cancer Treatment and Research.

Received on 26.07.2013 Modified on 20.09.2013

Int. J. Nur. Edu. and Research 1(1): Oct.- Dec., 2013; Page 05-08