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  • 1.
    Shrestha, Binjwala
    et al.
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Sahlgrenska Academy at University of Gothenburg, Sweden .
    Onta, Sharad
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal .
    Choulagai, Bishnu
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden .
    Poudyal, Amod
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal .
    Pahari, Durga Prasad
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal .
    Uprety, Aruna
    Rural Health and Education Trust, Kathmandu, Nepal .
    Petzold, Max
    University of Gothenburg, Sweden .
    Krettek, Alexandra
    Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg, Sweden .
    Women's experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal2014In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 14, no 1, article id 20Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women's experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices.

    METHODS: Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September-December 2012. All interviews occurred in outreach clinics in villages of the Dhading district.

    RESULTS: Study participants were 23-82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband's sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women.

    CONCLUSIONS: UP adversely affects women's daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP.

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