The National AIDS Control Organisation (NACO) has estimated that the annual incidence rate of sexually transmitted infections (STIs) is around 5 per cent in the adult population, which implies that about 40 million new STI cases occur annually in the country. In a community-based STI prevalence study conducted by NACO/ICMR/WHO, it was estimated that the STI prevalence ranged from 4.7 to 6.2 per cent.
Reproductive Tract Infections (RTIs) are infections of the reproductive organs that are caused by various germs. Though RTIs can occur in both men and women, they are more common in women, because their body structure and abortions and deliveries make it easier for germs to enter.
Reproductive organs can get infected because of trauma during delivery, unhygienic practices during delivery and abortions, as well as overgrowth of germs. Poor general health, poor genital hygiene and early marriage are all factors that can make women prone to these infections. Significant number of women in India suffer from reproductive health problems. Women are more vulnerable to these infections due to biological factors.
Why are these diseases not addressed?
Women are usually too shy and unwilling to talk about these problems. They have been taught to silently suffer problems related to sex. There is also a fear factor. There is a reluctance to seek medical treatment because of inadequate sex education and less access to medical care. The ?decision-makers? at home, like the mother-in-law, would allow a woman to be taken to a health worker if she suffers from pregnancy-related problems or infertility, but not for seemingly ?trivial? symptoms. Even our health system does not adequately respond to these needs of women. Our doctors often lack knowledge of population-based STI detection and prevention, evidence-based clinical decision-making, patient interviewing skills (particularly communication skills to understand their sexual behaviour) and counselling skills.
STIs have been badly neglected because they do not kill the person directly. They usually remain inside a woman'sbody, giving her chronic abdominal and back pain or making her infertile. Many women keep on suffering and remain silent.
Unless treated early, RTIs/STIs can lead to several complications, ranging from pelvic inflammatory disease (PID) and infertility, to increased risk of HIV infections, ectopic pregnancy , cancer of the cervix and death. There can be pregnancy-related complications like premature deliveries, low-birth weight babies, stillbirths, abortions or birth defects. Newborns can also get eye infection from the mother'sbirth canal, eventually leading to blindness and pneumonia.
Role of Civil Society
Advise women and families to have deliveries in hospitals?PHCs only. Delivery should be conducted by skilled persons only. Abortions at registered hospitals only. Going to the quacks means inviting trouble for life-time. Maintenance of hygiene.
Women should be encouraged to seek treatment from qualified doctors. You can help women get services by going with them to PHC/hospital in city. Women generally feel shy and awkward to talk about it. Complete treatment as advised by qualified doctor is a must. The partner should also receive treatment in cases. Health volunteers should counsel the family and seek the help of nurse/doctor, wherever required. Raise awareness about the causation, transmission and prevention of RTIs and STIs. Emphasise the importance of early treatment and partner management. Once in a year checkup at PHC/Hospital, even if there is no complaint.
(The writer is Chairperson, Women Wing of Indian Medical Association.)
