Reproductive Tract Disorders among Afghan Refugee Women Attending Health Clinics in Haripur, Pakistan

By Balsara, Z. P.; Wu, I. et al. | Journal of Health Population and Nutrition, October 2010 | Go to article overview

Reproductive Tract Disorders among Afghan Refugee Women Attending Health Clinics in Haripur, Pakistan


Balsara, Z. P., Wu, I., Marsh, D. R., Ihsan, A. T., Nazir, R., Owoso, E., Robinson, C., Darmstadt, G. L., Journal of Health Population and Nutrition


INTRODUCTION

Decades of strife have caused millions of Afghans to flee violence, political oppression, and economic instability (1) to become one of the largest groups of refugees in the world (2). Many live in neighbouring countries, such as Pakistan (2). Within Pakistan, an estimated 62% of Afghan refugees live in the Northwest Frontier Province (3).

In 1991, the Pakistan/Afghanistan office of Save the Children-USA joined the Safe Motherhood Initiative to provide healthcare to the refugees living in the Haripur camps in the Northwest Frontier Province. In 1998, as not much was known about the prevalence of morbidities due to RTIs within the Afghan refugee community, a clinical study was initiated to explore the extent of morbidity and possible associated behavioural factors. Much of past research on health of the refugee women has focused on women's delivery-related health, with particular emphasis on maternal mortality ratio (MMR). However, the MMR does not adequately represent other issues that can severely affect women's health, such as reproductive tract infections (RTIs). Untreated or improperly-treated RTIs can have severe, long-term sequelae, such as pelvic inflammatory disease (PID), infertility, ectopic pregnancy, low birthweight of offspring, or foetal loss (4-6), and can increase a woman's and her community's risk of acquisition and transmission of HIV (7-9).

Since this study was conducted in 1998, there have been several political changes in the area with dramatic repercussions for Afghan refugees. Significant repatriation efforts are being exerted, resulting in an often-fluctuating refugee population (3). A recent report by the United Nations High Commissioner for Refugees (UNHCR) estimated that, as of end-2008, there were more than 2.8 million Afghan refugees. Approximately 1.8 million of these refugees continue to live in the UNHCR-supported refugee camps in Pakistan, with very little improvements in living conditions (2). Although this study was conducted in 1998, there have been no studies published in the intermediate period addressing morbidity due to RTIs among Afghan refugee women. Therefore, our findings remain highly relevant and urgent.

The objectives of this study were to assess the prevalence of RTIs and other gynaecological disorders among Afghan refugee women attending Basic Health Units (BHUs) in Haripur, Pakistan, and to describe the most commonly-occurring RTIs. Behavioural factors that might be contributing to the development of RTIs were also explored.

MATERIALS AND METHODS

In 1998, there were 115,000 Afghan refugees of diverse ethnic groups, originating from different parts of Afghanistan, living in 18 refugee villages in Haripur. These refugee villages were served by a network of seven BHUs. The catchment area in this study included all the seven BHUs. In 1996, a verification exercise estimated that there were about 22,540 (19.6%) women of reproductive age among the Hairpur refugee population.

Training and pre-study preparations

Each BHU was staffed by a primary healthcare (PHC) team, headed by an Afghan female physician and a rotating male doctor catering to the gender-specific needs of the male population. Fieldwork was conducted from January to mid-March 1999. Before commencing fieldwork, a five-week preparatory phase of the project began in November 1998. During this phase, it was ensured that all the seven BHUs had the necessary equipment and materials required for the study. Medical Officers received training on the syndromic guidelines of the World Health Organization, diagnosis and management of reproductive tract disorders and other clinical issues, such as vaginal ecosystem, normal and abnormal flora, factors affecting vaginal flora, etc. Medical Officers also received training on interviewing techniques, collection of vaginal swab, plating of specimens, and preparation of slides. Field-testing of the questionnaire was conducted in the latter part of December 1998. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Reproductive Tract Disorders among Afghan Refugee Women Attending Health Clinics in Haripur, Pakistan
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.