Approaches to Researching Women's Reproductive Health
Since the late 1980s, comprehensive studies from Egypt, India, Nigeria, and Turkey have revealed the widespread prevalence of reproductive tract and other gynecologic disorders. These findings have prompted researchers to expand this work to explore the pervasiveness of these illnesses and to shed light on factors that place women at risk. But what are the best ways to conduct this type of research? Population Council senior program associate Shireen Jejeebhoy; Michael Koenig, associate professor, Bloomberg School of Public Health, Johns Hopkins University; and Christopher Elias, president, Program for Appropriate Technology, in Health (PATH), have collaborated on a book, Reproductive Tract Infections and Other Gynaecological Disorders: A Multidisciplinary Research Approach, that tackles this question. The editors draw upon the considerable experience of their contributing authors and provide a synthesis of the best approaches for studying this topic.
A spectrum of reproductive ailments can affect women. Reproductive tract infections (RTIs) are some of the most common. They can be transmitted sexually, produced by an overgrowth of normal microorganisms, or result from infections related to abortion, childbirth, sterilization, or the insertion of an intrauterine device. Women may also develop gynecologic cancers, endocrine disorders, genital prolapse (a painful condition in which the uterus or vagina is displaced downward), obstetric fistulae (a loss of tissue between the vagina and bladder and/or rectum caused by obstructed labor), infertility, sexual dysfunction, and menopausal symptoms. Discomfort caused by these conditions can impair a woman's ability to engage in a wide range of activities and can damage marital and sexual relationships and psychological well-being.
Although it is important to determine the prevalence of these disorders, it is equally crucial to understand their social, behavioral, and biomedical precursors. Jejeebhoy and Koenig offer a conceptual framework for exploring the social context of gynecologic disorders.
Key to this framework is the difference between disease and illness. Although many infections among women produce no symptoms, clinical examination and, in particular, laboratory tests can confirm the presence of disease. Conversely, many women who report symptoms have no medically verifiable disease. The authors underscore the fact that the association between self-reported, clinically diagnosed, and laboratory-tested conditions remains pool, and draw a distinction between disease, which can be medically confirmed, and illness, which involves women's perceived symptoms.
Best study practices
Researchers can employ community-based or facility-based studies to investigate women's reproductive health. When working within a community, a high level of rapport and interaction with the populace, including men and community leaders, is essential. …