Challenges encountered in community-based physiotherapy interventions for urinary incontinence among women in rural areas of Anand District of Gujarat, India.

ABSTRACT

BACKGROUND: It is necessary to understand the way women think about their health. There is a "culture of silence" among women regarding urinary incontinence (UI). Physiotherapy is proven effective mode of therapy in case of UI. OBJECTIVES: This study aimed to explore the attitude of the women toward UI, to understand the related sociocultural factors and health-seeking behavior, and to ascertain the challenges encountered in community-based physiotherapy interventions. METHODS: A qualitative study was conducted among women who refused to participate in a physiotherapy intervention for UI in the rural community of Gujarat, India. Fourteen in-depth key informant interviews were conducted using an interview guide. The responses were noted and compiled into a composite interview script. Interviews were not recorded due to nonavailability of consent. Interviews were reviewed by investigators and content analysis was carried out. Key themes were identified after multiple iterations. RESULTS: Most of the women were unaware of the UI and believed that it may be due to their gender or due to aging. Physiotherapy interventions were disregarded due to various reasons such as shy nature, lack of priority and privacy, dependency, self-neglect, and influence of social and cultural norms. CONCLUSION: Cultural and social systems were more important determinants of health seeking than health systems themselves particularly when sensitive issue such as UI in women of rural Western India was concerned.