Assessing burden, risk factors, and perceived impact of uterine fibroids on women’s lives in rural Haiti: implications for advancing a health equity agenda, a mixed methods study
| Autor: | Paul Farmer, Hannah Gilbert, Arlene M. Katz, Joia S. Mukherjee, Anatole Manzi, Mary C. Smith Fawzi, Christophe Millien |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Rural Population medicine.medical_specialty Uterine fibroids 03 medical and health sciences Social support 0302 clinical medicine Quality of life Surveys and Questionnaires medicine Prevalence Outpatient clinic Humans Women 030212 general & internal medicine Family history Poverty 030219 obstetrics & reproductive medicine Health Equity Leiomyoma business.industry lcsh:Public aspects of medicine Health Policy Public health Research Public Health Environmental and Occupational Health Health services research lcsh:RA1-1270 Middle Aged medicine.disease Health equity female genital diseases and pregnancy complications Haiti Cross-Sectional Studies Risk factors Uterine Neoplasms Quality of Life Female business Demography |
| Zdroj: | International Journal for Equity in Health International Journal for Equity in Health, Vol 20, Iss 1, Pp 1-17 (2021) |
| ISSN: | 1475-9276 |
| Popis: | Background Uterine fibroids, the most common cause of gynecologic surgery, have a reported cumulative incidence of 59% among Black women in the U.S. Uterine fibroids negatively impact the quality of women’s lives. No study has been found in the literature about fibroids in Haiti. We conducted a mixed methods study to assess the burden and risk factors of uterine fibroids, as well as their effects on women’s quality of life. Methods A convergent mixed methods study was conducted between October 1, 2019 and January 31, 2020 at MUH’s (Mirebalais University Hospital) OB-GYN outpatient department. Quantitatively, in a cross-sectional study 211 women completed consecutively a structured questionnaire. In-depth interviews with 17 women with fibroids and 7 family members were implemented for the qualitative component. Descriptive statistics were calculated for clinical and social demographic variables. Logistic regression was performed to examine associations between fibroids and related risk factors. An inductive thematic process was used to analyze the qualitative data. A joint display technique was used to integrate the results. Results Of 193 women analyzed 116 had fibroids (60.1%). The mean age was 41.3. Anemia was the most frequent complication— 61 (52.6%). Compared to women without uterine fibroids, factors associated with uterine fibroids included income decline (AOR = 4.7, 95% CI: 2.1–10.9, p = p = 0.005), and family history with uterine fibroids (AOR = 4.6, 95% CI: 1.6–13.6, p = 0.005). In contrast, higher level of education and micro polycystic ovarian syndrome were associated with lower prevalence (AOR = 0.3, 95% CI: 0.1–0.9, p = 0.021) and (AOR = 0.2, 95% CI: 0.1–0.97, p = 0.044), respectively. The qualitative findings delineate how contextual factors such as health system failures, long wait times, gender inequality and poverty negatively affect the quality of women’s lives. The poverty cycle of uterine fibroids emerged. Conclusions A vicious cycle of poverty negatively impacts access to care for uterine fibroids in Haiti. Health insurance, social support, and income generating activities may be keys to promote social justice through access to adequate care for women with uterine fibroids in Haiti. |
| Databáze: | OpenAIRE |
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