Reproductive Tract Disorders among Afghan Refugee Women Attending Health Clinics in Haripur, Pakistan- The Journal of Health, Population and Nutrition, Vol. 28, No. 5

Intrastate conflict - or known to most as civil wars - within the developing world attest to the greatest number of civilian displacements, more so than any other social or political upheaval. The Guardian's recent publication: "5.5 million people displaced over first half of 2014, say UN refugee agency", however, pays concern to, and addresses most frequently, the number of recently displaced people within the Middle East and the bordering regions of Africa. While conflict is a problem in-and-of itself, it is equally important in understanding the health problems within refugee camps in order to provide the necessary education for the people to prevent further health- related issues.

Balsara et al., in their journal: "Reproductive Tract Disorders among Afghan Refugee Women Attending Health Clinics in Haripur, Pakistan", emphasize this need. While this is a past study and most recently, Syrian refugees have surpassed Afghanis in the number of displaced people, the importance of the study is not who is displaced, but rather to underline the health issues effecting these refugee communities.

The objective of the study was to identify commonly-occuring reproductive tract infections (RTIs), asses the knowledge of the women with RTIs, as well as asses  the physical and behavioural factors contributing to the development of RTIs. Afghan women who had been displaced by conflict and were living in refugee camps in Haripur, Pakistan: Who had reproductive health-related complaints, were included in this study as well (n=634). 

The data collected included implementation of an interview-administered questionnaire, as well as a physical examination and laboratory tests with a descriptive analysis being conducted first. Qualitative data was then coded and analyzed using predetermined themes. Chi-square tests were used in determining the possible relationships between binary outcomes and categorical risk factors.

The outcomes were substantial: over three-fourths (76.7%) of the women who visited the clinics with complaints of reproductive complaints had, in fact, had an RTI. While nearly half (49.5%) of the women were diagnosed with some form of vaginitis, as well as 14.7% being diagnosed with clinical suspension of pelvic inflammatory disease (PID). Women with a cervical prolapse (p=0.033) or who cleansed after sexual intercourse (p=0.002) had a higher probability of having vaginitis. Yet, there was a substantial difference (p=0.017) in the prevalence of suspected PID among women who used mud to cleanse (11.1%). Whereas women who used water had an exponentially higher rate of prevalence at 18.8%. Women who used an old cloth or toilet paper had the lowest prevalence at 9.8% when cleansing after defaecation. In summary, specific physical and behavioural contributors to the high prevalence of RTIs in the refugee communities studied were identified and recommendations to counteract these health issues are recommended. 

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