RESUMO
The paper aims to understand the treatment seeking behavior and the experiences of men with male factor infertility. A cross-sectional study was conducted at consented hospitals/infertility centers in Mumbai, India in purview of the fact that men are not considered as important as a part of infertility treatment as women. An infertile man is defined here as one who is diagnosed with primary or secondary infertility, undergoing infertility treatment, irrespective of the fertility status of his wife. Primary data of 150 men undergoing infertility treatment from a variety of socioeconomic backgrounds was collected through semi-structured interviews. The initial effect of the infertility status led the men to feel depressed, guilty, shocked, and isolated. A large proportion of the respondents never discussed the problem with anyone except their wives. More than one third of the respondents consulted with Ayurvedic, Unani, Siddha, and Homeopathy (AYUSH) practitioners. Changes of doctors or clinics were more attributed to unsuccessful treatment cycles and success rate of other clinics than the referral by doctors. Destiny, bad luck, lifestyle, medical reasons, and late marriage are found as perceived causes of male infertility. Age above 40, younger age at marriage, marriage duration for 6 and more years, secondary infertility, self-employment, and higher income have significant association with longer time gap between marriage and initiation of infertility treatment. Based on study findings, we propose Belief and Practice theory where we elaborate the progression in treatment for male infertility. Men should be given due consideration in infertility treatment. They must be taken into consideration at an early stage of fertility evaluation due to the fact that minor problems of male infertility can be cured with modest medication. Proper Information Education and Communication (IEC) is essential for creating awareness in society on male infertility. Better counseling services during treatment and standardization of cost can help infertile men to manage treatment-related stress. Since infertility treatment is a time-consuming and exhaustive process, considering the timing for patient's income generating work, evening out patient department, and comprehensive knowledge dissemination at health centers can be improve male factor infertility treatment.
RESUMO
OBJECTIVE: The study explores the association between the household environment and the prevalence of anemia among children under the age of 5 years in India. Data and methodology: The study is based on 52,868 children under the age of 5 years, included in India's National Family Health Survey-3. The outcome variable was the prevalence of anemia. To understand the role of environment in determining child anemia, step wise logistic regression models consisting of environmental, child, socio-economic, and media exposure variables were applied. RESULTS: The occurrence of childhood anemia was higher in the North Eastern and Eastern regions compared to all other regions of India. Unclean fuel use, poor toilet facilities, staying in non-concrete house, exposure to smoking were important variables determining the prevalence of anemia. Smoking, when it was controlled with only socio economic factors, showed lesser impact on anemia, but when it got adjusted with socio-economic, child, and media variables together it showed an important impact as it increased the risk of anemia. CONCLUSION: Children under 5 years of age generally stay inside their house and are more exposed to the household environment. Thus, among these children there are multiple risk factors causing anemia along with the nutritional deficiencies. Better resources are needed to educate the public and to increase awareness for improved hygiene, sanitation and housing facilities, health and nutrition, etc. Along with a wider program to manage nutritional deficiency, anemia in children <5 years, there should be a holistic approach toward anemia control inculcating household environmental conditions and socio economic determinants.
