Gynaecological and Mental Health of Low-Income Urban Women in India

This thesis reports on the gynaecological and mental health of low-income urban women in Thane, India. The research objectives were to study the women's perception and experience of gynaecological symptoms, their association with mental ill-health and the role of social support and social networks in these two morbidities. A combination of quantitative and qualitative research methods was used in the form of a survey questionnaire and in-depth interviews. Gynaecological morbidity was measured by women's perception of morbidity and prevalence was calculated on women's reporting of symptoms. The Self Response Questionnaire (SRQ-20) was used to calculate mental ill-health 'cases'. Social support and social networks were separately explored for the first time in an Indian community setting using an adapted version of the Close Persons Questionnaire (CPQ). There was a high reporting (50.6%) of gynaecological symptoms in the community with reproductive tract infections, menstrual problems, urinary infections and prolapse being most commonly reported. 17.9% of the women were 'cases' of mental ill-health. Gynaecological morbidity was associated with poor mental health and affected women's social life. Women's age and reporting of a major illness were associated with gynaecological and mental health, whereas unemployment was associated with mental ill-health. Levels of social support were not associated with either morbidity. Higher levels of negative support were received from spouses, by the women. An extensively used social network appeared to protect against mental ill-health. The study's conclusions point to the need to plan more appropriate (participatory) and culturally sensitive programmes for the identification and treatment of gynaecological and mental health at the community level. The research findings emphasize the need for integration of mental health services at the primary health level especially in low income urban communities and the recognition of social networks in maintaining positive health.