Delay in presentation to healthcare facility in gynecology in-patients

BACKGROUND: Studies have shown that in our settings, women suffering from an illness report less frequently for health care seeking as compared to men, due to social and cultural factors. The hesitancy in seeking help is more for women suffering from reproductive tract infections.

OBJECTIVE: To compare the delay, between onset of symptoms and presentation to a health care facility in gynecology in-patients, with women admitted to medicine and surgery departments.

DESIGN AND METHODS: A cross sectional, analytical study was conducted at Holy Family Hospital, a tertiary level healthcare facility in Rawalpindi, Pakistan, during April to June, 2007. 100 In-patients from Gynecology and 50 each from Surgery and Medicine were enrolled using simple random sampling. Female patients irrespective of diagnosis, who were not critically ill, were included.Data was collected by face-to-face interviews. The Chi-square test was used to seek an association between variables. P value ≤0.05 was considered significant.

RESULTS: The median age of respondents was 38 years (Range 12-80 years). Majority of them (74%, n=148) were married and housewives (89%, n=179) with no formal education (60%).

59% (n=59) of gynecology patients showed a delay of months and years between onset of symptoms and presentation to a healthcare facility whereas frequency of this delay was 34% for surgery and medicine in-patients. There was a statistically significant association between being admitted to gynecology department and  having a delay from months to years (p<0.001; OR 2.793 [95% CI 1.573-4.692]). Uneducated women were more likely to have delay from months to years (p<0.027). The major reason cited for delay by gynecological patients was lack of awareness about disease and its symptoms (22%), followed by lack of finances (19%).

CONCLUSION: Delay in seeking healthcare lasting from months to years was more frequent in female in-patients with gynecological complaints as compared to those with medical and surgical problems.