Sexual and reproductive health of married men and access to services in a rural area of Bangladesh

Background and Objectives: Poor Sexual and reproductive health (SRH) in developing countries indicates an unacceptably high prevalence of preventable conditions, unnecessary suffering and often devastating consequences for individuals and families. Reproductive health was first acknowledged at the 1994 International Conference on Population and Development (ICPD) in Cairo and in The Millennium Development Goal (MDGs). There is increasing understanding that the MDGs cannot be achieved without substantial priority on the SRH and rights agenda. The study aims at setting a coherent and feasible research agenda on SRH that reflects the needs and demands of developing countries identifying the SRH realities in Bangladesh.

Methods: The study was carried out at Chakaria, a rural area of Bangladesh where 693 randomly selected married men were interviewed. 5% respondents were re-interviewed to maintain integrity of data. A pre-tested, semi-structured questionnaire was filled out. Confidentiality and secrecy was assured.

Findings: Of 693 respondents 60% stated that they had SRH concerns (including RTIs, STDs, HIV/AIDS, infertility,) and 63% of them received treatment (formal and/or informal). Leading SRH concerns included shortened duration of sexual intercourse (40%), frequent urination/incontinence (32%), loss of semen/nocturnal emissions (25%) and loss of semen before and after urination (23%), burning or pain when urinating (22%), and difficulty to maintain erection (18%). The majority of them (66%) received treatment from medical doctors, Kabiraj (Herbalist, 45%); village doctors (39%) and pharmacist (19%), homeopathy (25%); and street vendors (13%). Divorce, dissatisfaction between couples, psychological trauma etc. have been identified as major outcomes of those concerns.

Conclusion: The study explored that rural men are very concerned with SRH and most of these are anxiety based. Poor SRH knowledge is one of the major causes for those concerns. On the other hand the lack of accessible, convenient formal health care service leads to a failure to address SRH properly.