Perceptions of risk and behaviour change for prevention of HIV among married women in Mumbai, India.

Heterosexual transmission accounts for the majority of cases in India, an epicentre of the HIV/AIDS pandemic, with increasing rates of infection in married women contracting HIV from an infected spouse. Cultural roles and position of married women in Indian society render targeted risk-reduction programmes difficult. To investigate HIV/AIDS-related knowledge, perceptions, and behaviour change among married women in India, an interview-based survey was conducted with 350 married women in Mumbai, of whom 67% (236) were aware of HIV/AIDS. Although 59.3% (140) of those aware mentioned indiscriminate sexual activity as increasing risk of HIV, only two (41%) in five women perceived HIV as a threat to the community; one (12%) in eight perceived personal risk of getting infected as high; and only 7.2% (17) reported behaviour change to avoid infection. When probed for reasons for not changing behaviour, most women cited their personal behaviour of monogamy, not being in an at-risk group, such as commercial sex workers, and trust in their husbands. Education programmes among married women that enable better understanding of risks are urgently required. Since marriage and motherhood are important in the Indian cultural context, male spouses should be included in risk-reduction programmes.

Use of unqualified practitioners by disabled people in rural Bangladesh.

This community-based study examines health care seeking strategies with respect to types of practitioners consulted by disabled persons in rural Bangladesh. A primary health care specialist collected the data through household surveys. The study found that 81% of the disabled people had sought some forms of care from various health practitioners. Unqualified practitioners were found to be strongly involved (96%) in providing health care in this area. Persons with learning difficulties, speech difficulties, fits and strange behavior were more likely to seek treatment from unqualified practitioners. Mean delay and cost of treatment were significantly higher among the qualified practitioners than the unqualified practitioners. Visits to universally free public or government health care facilities were characterized as frustrating, inconvenient, time-consuming and less rewarding for disabilities by 34% of the disabled people. Further examination of the plurality of providers and practitioners in rural Bangladesh is warranted to see how best they can be used or re-trained to respond to the health care needs of disabled persons.

Impact of disability on quality of life of rural disabled people in Bangladesh.

This study examined the impact of disability on the quality of life of disabled people in rural Bangladesh. A primary healthcare specialist conducted a door-to-door survey in two villages in Bangladesh to collect socioeconomic and demographic information on the villagers and for identification of disabled people. Information on disability and how it affected their life was also obtained either from the disabled people or from their caregivers by interviewing them. The study revealed that disability had a devastating effect on the quality of life of the disabled people with a particularly negative effect on their marriage, educational attainment, employment, and emotional state. Disability also jeopardized their personal, family and social life. More than half of the disabled people were looked at negatively by society. Disabled women and girl children suffered more from negative attitudes than their male counterparts, resulting in critical adverse effects on their psychological and social health. A combination of educational, economic and intensive rehabilitative measures should be implemented urgently to make them self-reliant. Collaborative communication between professionals and parents, behavioural counselling, formation of a self-help group, and comprehensive support to families will reduce their suffering.

Disability problem in a rural area of Bangladesh.

For prevalence and pattern of disability as well as the socio-economic effects of disability, a community based study was carried out in a rural area of Bangladesh. A trained physician conducted a house to house survey in a population of 1906. An overall prevalence of disability of 8.5 percent was found. Major forms of disability were hearing disability (23%), visual disability (21%) and movement disability (15%). Disability was found to have considerable effects on educational attainment, employment and marriage. Many of these disabilities could be prevented by simple measures such as immunization, vitamin A supplementation and improving referral systems for early treatment. A substantial proportion could also benefit from relatively simple rehabilitatory measures.