Beruflich Dokumente
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PREPARED FOR
Second Professional MBBS Examination July 2015
Roll No
Registration No :
Batch
: SS-40 (C)
Session
: 2011-12
Date:
Date:
ACKNOWLEDGEMENT
Name:
Roll No.:
Group:
Batch: SS-40th C
CONTENTS
List of Figures
1-2
List of Tables
Abstract
4-5
Chapter- 1:
1.1 Introduction
6-8
1.2 Rationale
9-10
11
1.4 Objectives
11
12-13
14
conditions
1.7 Limitations of the study
15
16-26
Chapter-3: Methodology
27-28
Chapter-4: Results
29-56
Chapter-5: Discussions
57-61
Chapter-6: Recommendation
62
Chapter-7 Conclusion
63
Bibliography
64-66
Questionnaire in English
67-70
LIST OF FIGURES
Figure No.
Page
No.
1.
29
30
31
education
4
32
family
5
36
condition
6
37
menarche
7
38
39
40
pad/clothes
10
41
of cleaning of pad/clothes
11
42
44
13
46
48
50
51
17
52
53
LIST OF TABLES
Table
No.
1
Page
No.
33
members
2
34
35
income
4
43
menstrual cycle
5
45
menstrual period
6
47
menstrual problems
7
49
54
55
56
ABSTRACT
(42.6%). Those who didnt consult, in most cases (56%) they thought it
was normal. Most of them (64.5%) gave opinion regarding consultation
with doctor in order to prevent reproductive problems than personal
hygiene maintenance (23%) and health education (12.5%). The study
suggests that measures should be taken to strengthen further the ongoing
programs for improving knowledge and awareness about reproductive
health problems in the adolescent females.
CHAPTER: 1
1.1 INTRODUCTION
Over the last decade or so, there has been an increasing interest in
adolescents throughout the world. In Bangladesh the idea is
comparatively new. Adolescents and youth in Bangladesh are particularly
vulnerable to health risks, especially in the area of reproductive health.
This is due to their lack of access to information and services and social
pressure to perform as adults notwithstanding the physical, mental and
emotional changes they are undergoing. The current information and
services that are not specific to adolescents and the quality of such
information and services is often poor or inappropriate for this age
group.
The adolescent is a distinct group in the society, clearly different from the
children and the adults. This stage is always develops gradually without
proper attention, especially in the developing countries. International
conference on population and development (ICPD) held in 1994,
recognized the fact that the adolescent is a particular vulnerable group
and need special health care. Care of the reproductive organs lays the
foundation for the worlds demographic future.
Adolescent girls have very little access to information and health care.
They are vulnerable to reproductive health problems like spasmodic
dysmenorrhoea, irregular menstruation, scanty bleeding, leucorrhoea,
1.2 RATIONALE
10
11
1.4 OBJECTIVES
General objectives
To determine the pattern of reproductive health problems and
awareness among the adolescent females.
Specific objectives
1. To find out the socio demographic characteristics of adolescent
2. To determine the pattern of reproductive health problems among
the adolescent females.
3. To assess the knowledge on reproductive health problems among
the adolescent females.
4. To assess the awareness on reproductive health problems among
the adolescent females.
12
13
14
15
16
CHAPTER: 2
LITERATURE REVIEW
Adolescence is a phase of life that can be and is described by others in a
variety of ways. It can be examined chronologically, for it involves
physiological and cognitive maturational process. It can be described
physiological and it involves internal process of change in each
individual. It also can be discussed from the perspective of its
reverberations in the social and cultural worlds for it is during this time of
the that socialization into the rule of the adult takes place.
WHO defines adolescence as the period between 10 and 19 years age
which broadly corresponds to the onset of puberty and the age of
adulthood .In most parts world reproductive changes begin during
adolescence. It is a critical period which lays the foundation for
reproductive health of the individuals life time.
Therefore adolescent reproductive health involves a specific set of needs
distinct from adult need1
In Bangladesh almost one half of the women aged 22-24 years were
married by age 15 and by age 20 as high as 82 % of cohort has married.
Data gathered from the 1989 Bangladesh Fertility Survey indicate that a
relatively large proportion 18% of the adolescent marriages to place even
before the onset of menarche and there was a clustering of majority of
adolescent marriages immediately after the menarcheal period.2
Among all the countries in the region the incidence of adolescent
marriages tend to decrease. For instance, among the older women of aged
17
40-44 in Indonesia 72% were married before age 20 but among 20-24 age
cohort only 48% did the same, thus incidence of adolescent marriages
were declined by 24% points.
However the level of decline noted in Bangladesh, India, Nepal is not
impressive; countries like Thailand and Philippines had a relatively low
proportion of adolescent marriages among the cohort aged 40-44, than the
former countries were nonetheless were further successful in reducing
early marriages by significant properties.2
Adolescents, especially in the urbanity are susceptible to the risk of many
harmful substance like drugs, influences of satellites media etc.as many
of the behavior pattern such as gender relations inappropriate education,
relation gap between parents leading onset of health damaging behaviors
and their future repercussions UNFPA negligence can give rise to
immediate and long term problems with negative effects on individuals
and societies. One of the most important commitments a country can
make for its future economy, social and political progress and stability is
to seriously address and satisfy the health and development of health of
adolescents.3
There are the many adolescent programs in Bangladesh at present a
number of NGOs are involved with adolescents program. In general these
organization can be categorized under two main headings.
NGOs who are providing funding and technical assistant program to
implement adolescents programs and NGOs who are implementing these
programs in the field. Most of the NGOs started their adolescents
program in 1995 and thereafter. Adolescents are the parents, and leaders
of the tomorrow. It requires investigation in the potential of the young
people and helping them to solve problems. Population council conducted
18
the survey with the objective to collect information about the organization
working with the adolescents or youth. The survey was conducted into
two phases, initially names and addresses of organizations working in the
fields were collected from various sources (AFLE forum, DAWN forum
ACTION AID, BPHC ADAB,NGO Directory Examinations of these
reports suggests that a total of 188 organizations are working with the
adolescents. These organizations started their adolescents program with
the objectives to promote and support individual development for a better
life, removal of illiteracy. In addition these organization assist
adolescents on legal issues regarding violence and abuse.4
Future
programs
intended
to
incorporate
Reproductive
Health
structured
questionnaire
to
participating
female
19
20
21
22
23
24
In Nepal, 23% of the population falls in the age group 13-19 years
according to annual survey, 1997. A study conducted from July 1st 1997
to July 1st 1998 regarding adolescent gynecological problem that needed
hospitalization revealed that among 36 patient 3 of them was suffering
from puberty menorrhagia. In USA adolescents girls suffer commonly of
various problems. Among them commonest are amenorrhoea, DUB,
dymenorrhoea, irregular periods, nutritional anaemia. Nutritional anaemia
is found 8% of adolescent female. They are prone to prolonged and heavy
bleeding during early menstrual period.9
In Bangladesh the reproductive health care needs of adolescents is a
pressing problem, given that approximately 25 percent of the countrys
population of 132 million people are adolescents. To address their needs,
the Population Council, in collaboration with the Urban Family Health
Partnership (UFHP) and with financial support from the US Agency for
International Development (USAID), launched a pilot project in the
northwestern part of Bangladesh to improve the reproductive health of
adolescents (Research Update No 1 for detailed description of the
project). In the project areas, three interventions (community school and
clinic) were introduced to examine the effectiveness of reproductive
health education and an adolescent-friendly service delivery system. This
research update describes the experimental interventions and presents
important findings from surveys of parents and pharmacies. 11
The operations research study additionally implemented the school-based
intervention in eight schools in Dinajpur among students of classes VIII
and X (ages 13 to 16). Students attended 15 participatory sessions (using
a newly developed RH curriculum) taught by school teachers covering
mainly reproductive health and few general topics. The course topics
included changes in adolescence, personal hygiene , environment and
25
safe water, food and nutrition, gender, drug abuse, sexual relations and
sexual abuse, reproductive tract infections (RTIs), STDs, HIV/AIDS,
childbirth and family planning, antenatal care (ANC), post-natal care,
child health and immunization , population, marriage law and legal rights.
The program had effectively used school teachers to deliver the RH
courses in school, instead of NGO workers (as commonly done by other
programs). A total of 24 teachers (19 females and 5 males) were trained
for 4 days of the RH curriculum followed by refresher training on
pedagogical technique after 6 months. 11
Findings from the Parents Survey before introducing the experimental
interventions.(community school and clinic) the study conducted a survey
of parents in the intervention and control areas. The objective of the
survey was to understand perception of parents or guardians about RH
needs of adolescents. The socio demographic characteristics of the
parents or guardians showed that male parents or guardians were better
educated than female parents or guardians. Most of the female parents or
guardians (85%) were housewives and only 5% were engaged in business
and service. Male parents or guardians were primarily engaged in
business and service and they (72%) reported higher levels of
contraceptive use than female parents or guardians (60%). Approximately
68% of parents or guardians reported two as the desired number of
children. The findings showed that education and employment of children
were the two most important goals of parents. Approximately one-third of
the respondents suggested that the activities of children should be
monitored closely to protect them from risky behavior.11
26
27
CHAPTER: 3
METHODOLOGY
1. Study design
This was a cross sectional type of descriptive study.
2. Study place
Selected villages of Keranigonj Upazilla under the district of
Dhaka.
3. Study period
This study was conducted from 08-03-2015 to 10-03-2015.
4. Study area selection
Selected villages of Keranigonj upazilla under Dhaka district ware
selected for study.
5. Study population.
All the adolescent female of 10 to 19 years of the study area.
6. Sample size.
After giving the consent who are willing to provide the data
constitute the sample size about 400.
7. Sampling technique
Purposive sampling technique was adopted.
8. Research instrument.
Data was collected by using semi-structured questionnaire. Pre
tested semi-structured questionnaire was used keeping in mind the
objective of the study.
9. Data collection procedure.
Each household was visited by student before data collection; the
purpose of the study was explained to the respondents so that they
could understand the aim of study and meaning of the questions of
the questionnaire. After short discussion of the study, face to face
28
29
CHAPTER: 4
RESULTS
48%
8.75%
9-12
12 years
13-16
16 years
17-20
20 years
43.25%
Figure 1 shows the distribution by age. Among the 400
interviewed respondents of 35(8.75%) are 9-12 years,173
173
(43.25%) are 13-16
16 years,192 are 17-20 years(48%)
30
5.75%
Islam
Hinduism
94.25%
31
60%
50%
40%
30%
20%
10%
0%
32
8.25%
Nuclear
family
Joint/extende
d family
91.75%
Figure 4 shows the distribution of respondents by religion.
Among 400 interviewed 367(91.75%) were nuclear family &
33(8.25%) were joint/extended family
33
Number
Percentage
2-3
4-5
6-7
8-9
10-11
12
Total
66
126
112
48
37
11
400
16.5%
31.5%
28%
12%
9.25%
2.75%
100%
34
Occupation of father
Number
Percentage
Farmer
Day laborer
Rickshaw puller
8
105
13
2%
26.25%
3.25%
Service holder
80
20%
Businessman
Total
194
400
47.5%
100%
35
N=400
Number
Percentage
5000
5001-10000
10001-15000
15001-20000
>20000
Total
7
48
322
27
6
400
1.75%
12%
80.5%
6.75%
1.5%
100%
36
60%
50%
40%
30%
20%
10%
0%
Kacca
Pacca
Semi-pacca
37
150.00%
100.00%
50.00%
0.00%
9-11years
12-14years
15-17years
38
38%
Married
Unmarried
62%
39
Figure 8: Distribution
istribution of the respondents by type of
tampon used during menstruation
N=400
2.50%
%
45%
Sanitary
napkin
Old clothes
Cotton
51.25%
40
43.75%
Yes
No
56.25%
41
100%
80%
60%
40%
20%
0%
water only
soap
soap&savlon
42
3.50%
Yes
No
96.50%
Figure 11 shows distribution of the respondents by knowledge
43
Menstrual cycle
Number
Percentage ( % )
187
55.12 %
175
44.88 %
Total
362
100 %
44
3.58%
Yes
No
96.42%
45
Menstrual Period
Number
Percentage ( % )
1-3 days
28
7.25%
1-5 days
336
87.5%
1-7 days
22
5.7%
386
100%
Total
46
31.75%
68.25%
Yes
No
47
N = 273
Menstrual Problems
Scanty bleeding
Excessive bleeding
Painful bleeding
Total
Number
Percentage (%)
86
31.5%
115
42.12%
72
26.37%
273
100%
48
N = 400
39.75%
60.25%
Yes
No
49
N = 241
Menstrual Problems
Scanty bleeding
Excessive bleeding
Painful bleeding
Total
Number
Percentage (%)
86
31.5%
115
42.12%
72
26.37%
273
100%
50
N = 400
250
53.25%
200
37.25%
150
100
50
5.25%
4.25%
Friends
Relatives
Mother
Elder sister
51
N = 400
Yes
36.67%
No
63.33%
52
16.20%
13.04%
7.51%
Scanty
bleeding
Excessive
bleeding
Painful
bleeding
Whitish
discharge
Itching
53
44%
56%
Yes
No
54
Consulted with
Number
personnel
Percentage
(%)
Mother
96
42.6 %
Elder sister
55
24.4 %
Friends
48
21.3 %
Relatives
15
6.6 %
Doctors
11
4%
225
100 %
Total
55
Number
Percentage
Its Normal
98
56 %
Felt shy
35
20 %
42
24 %
175
100%
about it
Total
56
N = 400
Preventive
Number
Percentage
measures
Hygiene Practice
127
23 %
Health Education
50
12.5%
Medical advice
223
64.5%
Total
400
100 %
57
CHAPTER:5
DISCUSSION
58
59
60
29.64%
had
whitish
discharge,16.20%
had
scanty
61
62
CHAPTER: 6
RECOMMENDATIONS
The study findings in respect of reproductive health problems and
awareness among adolescent females lead to make following
recommendations:
63
CHAPTER: 7
CONCLUSIONS
64
BIBLIOGRAPHY
65
66
18. Singh MM, Devi R, Gupta SS. Awareness and health seeking
behavior of rural adolescent school girls on menstrual and reproductive
health problems. Indian J Med Sci 1991; 53: 439-43.
19. Anonymous. Population Reference Bureau. Women of our world
Washington, USA: The organization; 1998; 5-9.
67
Questionnaire
ID No.:
Village: .. Union: Upazila: Keranigonj
68
69
70
Date:
...
Name and signature of the interviewer
Roll No.