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
Abstract 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 conduct...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-01-01
|
| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-020-01327-9 |
| _version_ | 1818426275067330560 |
|---|---|
| author | Christophe Millien Anatole Manzi Arlene M. Katz Hannah Gilbert Mary C. Smith Fawzi Paul E. Farmer Joia Mukherjee |
| author_facet | Christophe Millien Anatole Manzi Arlene M. Katz Hannah Gilbert Mary C. Smith Fawzi Paul E. Farmer Joia Mukherjee |
| author_sort | Christophe Millien |
| collection | DOAJ |
| description | Abstract 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 = < 0.001), excessive expenses for transport (AOR = 4.4, 95% CI: 1.6–12.4, 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. |
| first_indexed | 2024-12-14T14:27:14Z |
| format | Article |
| id | doaj.art-0d16d76ab6df45f8a4528e68233b9450 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-14T14:27:14Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-0d16d76ab6df45f8a4528e68233b94502022-12-21T22:57:54ZengBMCInternational Journal for Equity in Health1475-92762021-01-0120111710.1186/s12939-020-01327-9Assessing 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 studyChristophe Millien0Anatole Manzi1Arlene M. Katz2Hannah Gilbert3Mary C. Smith Fawzi4Paul E. Farmer5Joia Mukherjee6Partners In HealthPartners In HealthDepartment of Global Health and Social Medicine, Harvard Medical SchoolDepartment of Global Health and Social Medicine, Harvard Medical SchoolDepartment of Global Health and Social Medicine, Harvard Medical SchoolPartners In HealthPartners In HealthAbstract 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 = < 0.001), excessive expenses for transport (AOR = 4.4, 95% CI: 1.6–12.4, 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.https://doi.org/10.1186/s12939-020-01327-9Uterine fibroidsRisk factorsWomenPovertyHaiti |
| spellingShingle | Christophe Millien Anatole Manzi Arlene M. Katz Hannah Gilbert Mary C. Smith Fawzi Paul E. Farmer Joia Mukherjee 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 International Journal for Equity in Health Uterine fibroids Risk factors Women Poverty Haiti |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Uterine fibroids Risk factors Women Poverty Haiti |
| url | https://doi.org/10.1186/s12939-020-01327-9 |
| work_keys_str_mv | AT christophemillien assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy AT anatolemanzi assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy AT arlenemkatz assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy AT hannahgilbert assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy AT marycsmithfawzi assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy AT paulefarmer assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy AT joiamukherjee assessingburdenriskfactorsandperceivedimpactofuterinefibroidsonwomenslivesinruralhaitiimplicationsforadvancingahealthequityagendaamixedmethodsstudy |