Services for women's sexual and reproductive health in India: an analysis of treatment-seeking for symptoms of reproductive tract infections in a nationally representative survey

• Published in: BMC women's health 2020-07, Vol.20 (1), p.156-156, Article 156
• Main Authors: Bhasin, Shikha, Shukla, Ankita, Desai, Sapna
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age groups; Childrens health; Clinical decision making; Cross-Sectional Studies; Decision making; Domestic violence; Educational Status; Family planning; Female; Fertility clinics; Gynecology; Health Behavior; Health care policy; Health Care Surveys; Health facilities; Health Knowledge, Attitudes, Practice; Health planning; Health policy; Health services; Health Services Accessibility; Health surveys; Higher education; Households; Humans; India; India - epidemiology; Infection; Infections; Marital status; Maternal & child health; Medical research; Medical screening; Menstruation; Middle Aged; Mobile businesses; Morbidity; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - statistics & numerical data; Polls & surveys; Private sector; Public sector; Regions; Reproductive Health; Reproductive Tract Infections - epidemiology; Reproductive Tract Infections - therapy; Reproductive tract infections; gynaecological morbidity; Rural areas; Rural Population - statistics & numerical data; Sexual behavior; Surveys; Surveys and Questionnaires; Symptoms; Treatment seeking; Ulcers; Urban Population; Women; Women's Health; Women's Health Services - statistics & numerical data; Womens health; Young Adult
• ISSN: 1472-6874; 1472-6874
• DOI: 10.1186/s12905-020-01024-3

Women's health policy in India has had a longstanding focus on maternal health and family planning. Recent policy highlights the importance of expanding women's access to a broader range of sexual and reproductive health services. However, there has been very limited analysis of national survey data to examine the current status of treatment utilisation, variation across states and progress over time. This paper examines women's treatment patterns for reproductive tract infections in India, based on data collected in the National Family Health Survey, a cross-sectional, nationally representative household survey conducted between 2015-16. The survey covered 699,686 women between the ages 15 and 49, of which 91,818 ever sexually active women responded to questions related to symptoms of reproductive tract infections. We estimate prevalence of reported symptoms and treatment-seeking, describe regional variation and utilise multivariable logistic regression to identify factors associated with women's treatment-seeking patterns. Thirty-nine percent of women who reported symptoms of reproductive tract infections sought any advice or treatment. Women's reported treatment-seeking in India has not changed since the last national survey a decade earlier. Reported symptoms and treatment-seeking varied widely across India, ranging from 64% in Punjab to 8% in Nagaland, with no clear regional pattern that emerged. Seventeen percent of symptomatic women sought services in the public sector, an improvement from 11% in 2005-06. Twenty-two percent utilised the private sector, with wide variation by states. National-level multivariable logistic regression indicated that treatment-seeking was associated with age, higher education, higher household wealth and having been employed in the past year. Women in the 25-35 age group had higher odds (aOR1.27; 95% CI: 1.10,1.50) of seeking treatment compared to both younger (15-19 years) and older (35 years and above) women, along with women with more than eight years of schooling (aOR: 1.23; 95% CI: 1.05,1.44) and from richer wealth quintiles (aOR: 1.53; 95% CI: 1.35,1.83). Women's use of services for reproductive tract infections remains a challenge in most parts of India. Our findings highlight the need to address barriers to seeking care and to improve measurement of gynaecological ailments in national surveys.