title: Treatment-seeking for selected reproductive health problems: behaviours of unmarried female adolescents in two low-performing areas of Bangladesh.
abstract: OBJECTIVE
  The reproductive health needs of unmarried adolescents in Bangladesh are largely unmet. This study aimed to explore treatment-seeking behaviour of unmarried female adolescents for selected reproductive health (RH) concerns in two low-performing areas of Bangladesh.
  
  
  METHODS
  As part of a large community based-project, a cross-sectional survey was conducted from November 2006 to March 2007. From each of two select study areas, 800 unmarried female adolescents aged 12-19 years were selected for participation by simple random sampling through household listing and were recruited into the study. Trained interviewers administered a structured questionnaire to participating female adolescents. Descriptive and bivariate analytic methods were used compare RH conditions and healthcare seeking behaviour of adolescents across urban and rural settings.
  
  
  RESULTS
  Approximately 50% of the sample reported experiencing menstrual problems in the last year. The predominant problems reported by participants included: lower abdominal pain, back pain, irregular menstruation, and excessive bleeding during menstruation. Irrespective of study area, only 40% of the female adolescents with menstrual problems sought treatment from qualified physicians. Otherwise, utilization of healthcare facilities and care providers for reported problems varied significantly by rural and urban areas. Higher proportions of adolescents in the urban setting (15%) also reported recent symptoms of sexually transmitted infections (STIs), compared to those in the rural setting (9%; p<0.001). Across sites, however, self-treatment was the most commonly reported method of care for those who experienced any symptoms of STI.
  
  
  CONCLUSIONS
  In general, treatment-seeking behaviours by unmarried female adolescents was low for menstrual problems. A vast majority of unmarried female adolescents practiced self-care for symptoms of STIs while only small proportions sought treatment from qualified physicians. These findings emphasize the need for offering relevant information on RH issues and introducing confidential adolescent-friendly reproductive healthcare facilities to enable unmarried female adolescents access to RH services when necessary.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh. humayun@icddrb.org.
authors.forename: Humayun
authors.initials: H
authors.lastname: Kabir
authors.forename: Nirod Chandra
authors.initials: NC
authors.lastname: Saha
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Wirtz
authors.forename: Rukhsana
authors.initials: R
authors.lastname: Gazi
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001459:Bangladesh; D002648:Child; D003219:Confidentiality; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012424:Rural Population; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000628:therapy*; D012847:Single Person; D011795:Surveys and Questionnaires; D055815:Young Adult