Management of reproductive tract infections in rural Bangladesh

This book chapter presents findings from a study of treatment practices for reproductive tract infections (RTIs) among union-level family planning service providers in Bangladesh. The aim was also to determine client knowledge and perceptions of RTIs and service-seeking behavior of clients and their husbands. Data were obtained from clinic observations exit interviews among 100 RTI clients interviews with 24 village practitioners and service registers. The study was conducted at Mohakal and Paira unions of Abhoynagar thana in Jessore District in southwestern Bangladesh. The study area is known for high contraceptive prevalence and is a field site for the Maternal and Child Health and Family Planning (MCH-FP) Rural Extension Program of the ICCDR. The study area had been the site of the MCH-FP Program for over 10 years. Findings indicate that 100 clients attended Health and Family Welfare Centers (HFWCs) and Satellite Clinics (SCs) for the treatment of RTIs during June-October 1995. 69 clients were current contraceptive users. The most common symptom of womens RTIs was a white discharge while husbands with symptoms commonly reported itching. The mean duration of suffering from symptoms was 4.5 years for clients and 4 years for husbands. 10 clients used home remedies. 33 clients only received treatment from the HFWCs/SCs. Treatment practices were evaluated for history taking physical examination drugs used and advice given to clients. Only 30 clients were asked the disease history. None of the clients were physically examined. The most commonly prescribed drug was metronidazole. 75% of clients were prescribed less than the 14-tablet standard dose of metronidazole. 50% of clients received some advice mostly drug-related. 66% of clients and most unqualified medical practitioners were unfamiliar with the causes of RTIs and 75% did not understand modes of transmission. 66% did not know how to prevent RTIs.