Study on gynecological problems and awareness of reproductive health amongst adolescent girls residing at Khaja Bazaar, Kalaburagi, Karnataka

 

Dayalaxmi Shedole¹, Sneha K^2*

 

¹Assistant Professor, Department of Community Medicine, Gulburga Institute of Medical Sciences, Kalaburgi, Karnataka, INDIA.

²Assistant Professor, Department of Community Medicine, Bidar Institute of Medical Sciences, Bidar, Karnataka, INDIA.

 

Abstract               Background: Adolescence is the transitional period of life when the care free child becomes the responsible adult. Reproductive health covers all aspects of adolescent health. It is an umbrella concept, consisting of several distinct, yet related issues such as abortion, child birth, sexuality, contraception and maternal mortality. Biological, social, cultural, economical and behavioral factors play an important role in determination of reproductive health. Present study was made an attempt to note the various adolescent girls’ problems so as to aid in improving general health of womanhood and also know about their awareness and knowledge to promote health education. Methods: A cross-sectional study was conducted amongst 200 adolescent girls about gynecological problems and awareness regarding reproductive health from May 2016 to August 2016 at Khaja Bajar area near urban health training centre (UHTC) of Dept. of Community Medicine of KBN Institute of Medical Sciences, Kalaburgi, Karnataka Results: A total of 200 adolescent girls were included as study subjects, majority of them were in the age group of 12 to 15 years and unmarried. About 45% of girls complained of irregular menstrual flow associated with dysmenorrhea. Conclusion: Among the various gynecological problems studied, most common are menstrual irregularities and awareness regarding reproductive health was found to be satisfactory.

 

 

 

INTRODUCTION

Adolescence is a transition phase through which a child becomes an adult. World Health Organization (WHO) has defined adolescence as the age range of 10-19 years. It is the period between childhood and adulthood, marked by enhanced food requirement and basal metabolic activities and bio-chemical activities, endogenous processes like hormonal secretions with their influence on the various organ systems.¹ Reproductive health cover all aspects of adolescent health. It is an umbrella concept, consisting of several distinct, yet related issues such as pregnancy, child birth, sexuality, contraception and maternal mortality. Biological, social, cultural, economical and behavioral factors play an important role in determination of reproductive health.² In India, adolescent girls account for a little more than one-fifth of the population (21.4%). Out of an estimated 200 million adolescents, girls account for slightly less than 100 million due to disproportionate sex ratio.³ Menarche marks the beginning of women’s menstrual and reproductive life and occurs during early adolescence when teenage girls are beginning to emotionally separate themselves from their families, as well as to grapple with their unfolding female sexuality. Thus, it is pertinent to examine various influencing factors of teenage girls’ expectations of menarche to facilitate the understanding of their transition to womanhood, which may have significant implications for the overall promotion of their health.⁴ Empowerment of the adolescent girl is necessary to help her cope with the changes and promote awareness of health, hygiene and nutrition so as to break the intergenerational life cycle of nutritional and gender disadvantage and provide an enabling and supporting environment for self-development.⁵ In view with this the present study was conducted for better understanding and knowledge among the girls residing in our urban field practice area.
MATERIALS AND METHODS

A cross-sectional study was conducted amongst 200 adolescent girls about gynecological problems and awareness regarding reproductive health from May 2016 to August 2016 at Khaja Bajar area near urban health training centre (UHTC) of Dept. of Community Medicine of KBN Institute of Medical Sciences, Kalaburgi, Karnataka. The estimated prevalence of anaemia among adolescent girls as per National Family Health Suyvey-3 data was 56%.⁶ Considering this, by using formula n=4pq/l², sample size for our study was estimated, and allowable error 10%, the estimated sample size was 186 and it was rounded off to 200. A total number of 200 adolescent girls were included in the study. A pre-tested structural performa was used for data collection, questions were asked regarding their socio-demographic profile, menstrual history, vaginal discharge, and their awareness regarding STIs and HIV. Prior consent was taken and the purpose of study was explained. Complete confidentiality of their answers was assured to all the study subjects.

Inclusion and Exclusion Criteria: All the adolescent girls in the age group of 10-19 years who were residing in the study area for a minimum period of 6 months and willing to give their consent were included in the study. Adolescent girls who were terminally ill and pregnant were excluded from the study.

Data collection:Information was collected using face to face interviews based on a structured, pre-tested questionnaire. Pre testing was done on adolescent girls who are in the same age group (10-19 years), in a similar setting, to screen for potential problems in the questionnaire. The interviewers discussed the questionnaire thoroughly among themselves before data collection to decrease interviewer bias. With the exception of a few open ended questions, the interview was based on prompted questions.

Statistical Analysis: The data that collected further analyzed, tabulated and presented. Statistical analysis was done by using appropriate statistical tests like mean, percentage and chi square test whenever necessary.

RESULTS

Table 1: Socio demographic profile of study subjects

It was seen from Table 1 that majority of study subjects were in the age group of 13 to 19 years, and belong to Muslim community, staying nuclear family and belonging to class III according to B. G. Prasad classification, and have been educated till higher secondary.

Table 2: Gynecological history of study subjects

It was observed from Table 2 that out of 200 adolescent girls, 48.5% have attained menarche between 12-14 years, 47.1% have irregular menstrual cycle and 25.8% of study subjects complain of dysmenorrhea, whereas 73.7% of them gave history of excessive white discharge associated with foul smell (59.3%).

 

Table 3: Distribution according to education status and probable causes of white discharge

Chi-square: 3.456 p-value-0.024

As shown in Table 3 that on comparison of education status and probable cause of white discharge of study subjects, out of 200 study subjects 86.7% girls think infection as probable cause of white discharge, about 43.4% of them have studied till higher secondary, 22.3% of the girls considered it as normal and this difference was found to be statistically significant.

Table 4: Knowledge on pregnancy and contraception

It was seen from Table 4 that more than half of study subject are well aware of pregnancy, and the right age of child bearing is above 18 years (62.5%), where as the knowledge about contraception is very poor (27.3%).

 

Table 5: Awareness about HIV/AIDS and Its modes of transmission

As shown in Table 5 that amongst 200 adolescent girls more than half of them are aware of disease like HIV/AIDS, It was found that unprotected sex (43%) was the most common mode of transmission followed by contact with contaminated blood or blood transfusions (11%), accordingly to the knowledge of the study subjects.

Table 6: Distribution according to education status and modes of tranmission of HIV/AIDS

Chi-square:4.246 p-values: 0.042

As seen from Table 6 that on comparison of education with knowledge on transmission of HIV/AIDS, majority of adolescent girls educated upto higher secondary think that unprotected sex is common route of transmission of HIV/AIDS followed by mother to child transmission. This difference was found to be statistically significant.

DISCUSSION

Reproductive health is very important among adolescent girls because they are going to be mothers of tomorrow whose awareness and knowledge about reproductive health and problems is at most important for improving the nutritional, health and educational status of children in the state. Reproductive health is defined by WHO as a state of physical, mental and social well-being, and not merely the absence of disease in all matters relating to the reproductive system at all stages of life.  Reproductive health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when, and how often to do so.⁷ In India, adolescent girls account for a little more than one-fifth of the population (21.4%).⁸ Out of an estimated 200 million adolescents, girls account for slightly less than 100 million due to disproportionate sex ratio.³ In a study conducted at VIMS Bellary by Ramraju H et al⁹, Menstrual disorders were commonest gynecological problems (74%) followed by vaginal discharge (17%) and ovarian tumours (4%), whereas in our study subjects, 48.5% attained their menarche in the age group of 12-14 years, most predominant gynecological problem was irregular menstrual bleeding (47.5%), followed by dysmenorrehea (25%), excessive white discharge (73.1%) associated with foul smell (59.3%). of adolescent girls respectively. In a study done by Sharma P et al¹⁰, on problems related to menstruation amongst 198 adolescent girls observed the types and frequency of problems related to menstruation in adolescent girls and the effect of these problems on routine, they found that dysmenorrhea (67.2%) was the commonest problem and (63.1%) had one or the other symptoms of pre-menstrual syndrome (PMS), which was not seen among our study subjects. Another study done by Patil SN et al¹¹ found that the health problems among adolescent girls in rural areas of Ratnagiri District of Maharashtra, India, the majority (more than 3/4th) of adolescent girls were suffering from menstrual related problems which lead to reproductive morbidities. It was found that 68.9% of the study subjects were as far as problems related to menstruation cycle were concerned dysmenorrheal (44.2%) was the commonest problems faced by adolescent girls, irregular menses (16.9%), irritation (21.7%), constipation (11.3%), tightness in chest (10.6%) and white discharge (38.3%). In our study, amongst 200 adolescent girls, more than half of them are aware of HIV/AIDS, and found that unprotected sex (43%) was the most common mode of transmission followed by contact with contaminated blood or blood transfusions (23%). Similar observations were also noted study done by Gaash Basir et al¹² and also other studies conducted elsewhere.^13,14,15 However another study done by Bhan NB et al.¹⁶ showed that the awareness about HIV/AIDS was very low.

 

CONCLUSION

Most common gynecological problem was irregular menstruation followed by dysmenorrheal. The overall awareness with respect to menstruation problems like regularity, dysmenorrheal and associated symptoms of STDs like white discharge and its probable causes was low, where as the knowledge regarding reproduction like pregnancy and right age of child bearing was found to be satisfactory except awareness regarding contraception, which was upto 25% of study subjects. However the awareness levels of HIV/AIDS, its mode of transmission and prevention were satisfactory. At present, adolescent gynaecology remains an area to which increased awareness and greater attention should be given to protect and promote the health of teenagers. This can perhaps best be done by setting up specialized ‘Adolescent Gynaecological Clinics’.

 

ACKNOWLEDGEMENT

We thank all the adolescent girls who participated in the study and their parents who supported the study without them this study would not have been possible. Authors would like to thanks to all staff members of Community Medicine Department of KBNIMS, Kalaburgi, Karnataka for their guidance and support.

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