Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia

Abstract

BackgroundDespite known gender-specific differences in terms of prevalence, transmission and exposure to neglected tropical diseases (NTDs), there is limited discussion of the influence of gender in NTD programmes and interventions. There is a paucity of research on how gender interacts with NTD service provision and uptake. This study, part of broader implementation research in Ethiopia, applied a gender lens to health seeking for five NTDs: lymphatic filariasis, podoconiosis, schistosomiasis, soil-transmitted helminth infection and trachoma. Methodology/principal findingsThe study was conducted in a district of the Southern Nations, Nationalities, and Peoples' Region of Ethiopia where the five NTDs are prevalent. A qualitative methodology was adopted to explore participants' perspectives and experiences. Data generation methods included 20 interviews and four focus group discussions. Community members, volunteer Health Development Army leaders, Health Extension Workers and a range of health workers at the health post, health centre and hospital level (n = 59) were purposively sampled. Interviews and focus group discussions were audio recorded, transcribed verbatim into English then analysed through open coding, drawing on constant comparative methods.Gender related factors affected care seeking for NTDs and were described as reasons for not seeking care, delayed care seeking and treating NTDs with natural remedies. Women faced additional challenges in seeking health care due to gender inequalities and power dynamics in their domestic partnerships. Participants recommended raising community awareness about NTDs, however this remains problematic due to gender and social norms around appropriate discourse with members of the opposite gender.PLOS Neglected Tropical Diseases | https://doi. Funding:The study was co-funded by COMDIS-HSD (comdis-hsd.leeds.ac.uk), a research consortium funded by UK aid from the UK government (www.gov.uk/government/ organisations/department-for-internationaldevelopment). The views expressed in this manuscript do not necessarily reflect the funder's Conclusions/significanceThe findings from this study provide crucial insights into how gender interacts with accessing health services, at different levels of the health system. If we are committed to leaving no one behind and achieving universal health coverage, it is essential to address gender disparities to access and utilisation of interventions delivered by national NTD programmes. Author summaryThis study provides insights into how gender influences peoples' access to health services for neglected tropical diseases (NTDs). There is considerable evidence to show that women and girls suffer a greater NTD burden due to their higher levels of poverty, lower education and social status. The psychological and social consequences of NTDs also tend to be worse for women. There is an urgent need to integrate NTDs into basic healthcare services, yet there is little evidence that can support a gender-based approach of how best to do so. This study...

Financial burden impact quality of life among Filarial Pathology Patients

“…In addition, women are more than 10 times more likely than men to have lymphoedema of the leg 7 . This trend is still consistent in other neglected tropical diseases such as trachoma where female caregivers most often come in contact with infected children than their male counterparts and thus are higher risks of infecting themselves 8 . Individuals suffering from lymphatic lariasis experience repeated larial attacks known as adenolymphangitis (ADL), which hinders patients from actively participating in both social and economic activities [9][10][11] .…”

Financial burden impact quality of life among lymphatic Filariasis patients

“…In addition, women are ten times more likely than men to have lymphoedema of the leg [ 7 ]. This trend is still consistent in other neglected tropical diseases such as trachoma where female caregivers most often contact infected children than their male counterparts and thus are at higher risks of infecting themselves [ 8 ]. Individuals suffering from lymphatic filariasis experience repeated filarial attacks known as adenolymphangitis (ADL), which hinders them from actively participating in social and economic activities [ 9 – 11 ].…”

Addressing barriers of community participation and access to mass drug administration for lymphatic filariasis elimination in Coastal Kenya using a participatory approach

“…Furthermore, women who are housewives may not have the freedom to make decisions on when to receive medical services without the consent of their husbands who most likely would be away fending for their families at the time of the CDDs’ visit to the household. Addressing gender disparities to ensure that no one is left behind in the fight against LF is an important factor for consideration as described in a study conducted in Ethiopia [ 30 ].…”