Factors enabling women with pelvic organ prolapse to seek surgery at mobile surgical camps in two remote districts in Nepal: a qualitative study

ABSTRACT

Background: Pelvic organ prolapse (POP) is a major reproductive health problemin Nepal, though many women delay seeking treatment. To address this, theNepalese government has been providing free vaginal hysterectomies with pelvicfloor repair to women in mobile surgical camps. Studies exploring factors thatenable women to attend these camp settings are limited. This study aimed toidentify factors that affected women seeking surgical treatment for POP at mobilesurgical camps.Methods: The study used a qualitative approach. Twenty-one women with POPwere recruited in two week-long mobile surgical camps held in two remote districtsin Nepal during April and May 2013. Data were collected from individual face-toface interviews and were analysed thematically.Results: Three themes and six subthemes emerged from the analysis. The firsttheme, “health-system factors”, suggests that accessibility and affordability ofthe treatment, and the supportive role of female community health volunteersfacilitate women to seek treatment in the camp. The second theme, “factorsrelated to sociocultural norms”, reveals that reaching the end of reproductiveyears and approval by relevant influential family members empowers women totake up surgical treatment in the mobile surgical camp. Similarly, the third theme,“individual-level factors”, includes women’s experience of POP, such as worseningsymptoms and fear of development of cancer, as factors enabling women to seektreatment.Conclusion: Enablers to seeking treatment at mobile surgical camps forwomen are related to the Nepalese health system, sociocultural norms andindividual experiences of women. Each of these factors should be consideredwhen conducting mobile surgical camps, if women’s uptake of treatment is to beenhanced