Reproductive Health of Women in Rural Area

A Study in Bogra District

1. Introduction

The components of reproductive health   may be identified as - family planning, safe motherhood, safe abortion facilities, infant and child care, male participation and responsible behaviour, adolescence reproductive health, infertility, reproductive tract infections, sexually transmitted diseases, HIV/AIDS, cancers of reproductive tract, reproductive health needs disables.

Study was conducted in Bogra district and three stage cluster sampling method was used for selecting respondents of the study. At the first stage, two upazilas (Sub-district) out of nine, from the district, were selected randomly. At the second stage, one Union Family Welfare Centre (UFWC) from each selected upazilas was chosen randomly. At the third stage, two villages: one nearby and another remote, were chosen from each selected UFWC. All the women who had given birth within a year or found pregnant at the time of data collection were considered the respondents of the study. Data was collected in July 2003. Total number of respondents was 260.

2.  Findings.

2.1.   Socio-economic Characteristics: Socio-economic characteristics of the respondents are measured in terms of age, education, occupation, landholding size, family size, affiliation with social institution, etc.

         Most of the respondents (70.39%) belonged to the early stage of their reproductive age i.e. below 25 years. Around one-third (33.46%) of the respondents were illiterate and 18.85% could sign only. Only 13 (5.00%) of them passed SSC examination and only one passed HSC examination. Most of the respondents, except three, were housewives, in terms of occupation. Only 9 of the respondents had secondary occupations and the occupations were work in small industries, maid servant, tailoring and housewife. Average number of children per women was only 1.93 and average family size was 4.40. Majority of the respondents (65%) belonged to the functionally landless families, i.e. owning land less than 0.05 acre and 4.62% had no land at all. The average landholding size of the families was 0.78 acres.

2.2. Use of Family Planning Methods: Out of 260 respondents 82 were pregnant and 178 had child of one year of age or less, so only 178 of the respondents were eligible to use family planning methods. It was found that 98.84% of the respondents knew the widely used methods like pill, injection and copper-T. Findings showed that 75.38% used contraceptive at least once in their life and adopted more than one method during their reproductive age. Widely used method was pill (95.91%) followed by injection (13.26%). Around 26% of the respondents never used contraceptives in their life. Major reasons for not using the methods were newly married and they wanted child in this stage, wanted more children without any reason, had only one child or they wanted child of opposite sex, etc.

         The respondents were asked whether they encounter any problem at the time of using the methods. Among 188 pill users 81.50% informed that they were suffering from vertigo. Majority of the users of injection (46.15%) were suffering from irregular menstruation and 19.23% informed that their menstruation was stopped.  Only 2 of the respondents used IUD and both of them felt pain at the lower abdomen.

2.3. Menstruation Regulation (MR): Out of 260 respondents only 13 (5.00%) did (MR.). It was done at own house, doctor’s chamber and upazila health complex by 61.54%, 23.80%, 15.38% respectively.  Majority of the MR was done by the Family Welfare Visitors (38.47%) which was followed by the homeopathy doctor 4 (30.77%).

2.4. Abortion: Only 8 of the respondents reported that they had experience of abortion. Of them 5 did induced abortion and in case of rest 3 it was unwanted. Among them 5 (62.50%), 2 (25.00%) and 1(12.50%) did abortion at clinic, own house and doctor’s chamber respectively. Out of 5 respondents who did induced abortion 4 did by the nurse and only 1 by the field worker of the family planning department.

2.5.   Antenatal

2.5.1. Routine Checking: Position of the fetus at the time of the pregnancy was checked by 69.23% respondents. Of them 47.78% were examined by the field workers of the health/family planning department at their own house or relatives’ house, 26.11% at UWC, 14.44% at Upazila Health Complex, 6.11% at doctor’s chamber, 2.78% at clinic and 2.78% at Bogra Sadar Hospital. Apart from examination of the position of the fetus 30.00%, 15.55%, 12.22% and 4.44% of the respondents were examined or monitored about their weight, blood pressure, urine and blood respectively.

2.5.2. Food Intake: Almost all of the respondents (96.45%) knew that sufficient vegetable should be eaten during pregnancy period. Other foods like fruits, egg, milk, liver, small fish and meat were specified by 84.25%, 81.89%, 77.16%, 32.68%, 23.23% and 17.72% of the respondents respectively. A few of them mentioned that pulses, iodized salt and sufficient amount of water should be taken.

2.5.3. Vaccination: Tetanus Toxid (TT) vaccine is one of the important measures to avoid occurrences of Tetanus. It was found that 80.38% of the respondents took TT vaccine. Of them three doses, two doses and one dose were taken by 11.48%, 74.64% and 13.88% respectively. More than half of them (53.11%) vaccinated at their own house or neighbour’s house. Vaccine was taken by 27.85% at Union Family Welfare Centre and 17.22% at Upazila Health Complex.

2.6. Delivery Practice: Almost all the respondents (99.62%) knew that hospital or clinic is the safe place for delivery. However, in practice only 4.50% of them moved to the hospital or clinic for their delivery. Majority of the respondents (55.62%) did their delivery at their parent’s house and rest 37.70% did at their own house. In most of the cases (77.53%) delivery was attended by birth attendants and only 11.24% by the trained birth attendants.

2.7. Post Delivery Problems and Care: Out of 178 respondents 44 (48.46%) faced different types of problems after delivery of their last child. Around half of them (47.73%) suffered from pain at the lower abdomen. Anemia, weakness, excess bleeding and eclampsia were reported by 34.10%, 13.63%, 4.55%, 4.55% respondents respectively. In most of the cases (61.29%) of the respondents consulted Birth Attendants to solve the problems. Rest of the respondents consulted Village Doctor (16.13%), Homeopathy Doctor (12.90%) and Qualified Doctor (9.68%) at their chamber.

2.8. Knowledge about HIV/AIDS: Only 51 (19.62%) of the respondents knew the name of AIDS. Most of them (94.12%) mentioned illegal sexual relationship to be responsible for infection in this disease. Sharing of syringe and blood transfusion were mentioned by 62.74% and   13.73% respectively. Sources of information about the disease were Radio (23.53%), Television and relatives/ neighbours (5.88%). Rest 54.90% could not remember exactly from where they got the information.