title: Bangladesh Midlife Women's Health Study (BMWHS): methods, challenges and experiences.
abstract: OBJECTIVE
  To understand the challenges and experiences encountered during data collection for Bangladesh Midlife Women's Health Study (BMWHS) that investigated the low uptake of cervical cancer (CCa) screening barriers, understanding of breast cancer (BCa) knowledge and practices, the prevalence of urinary and fecal incontinence and menopausal symptoms.
  
  
  METHODS
  A multistage cluster sampling technique was used to recruit women from the 32 districts of Bangladesh that had offered CCa screening. Female interviewers were trained to undertake structured face-to-face interviews that incorporated both non-validated and several validated questionnaires, such as Question for Urinary Incontinence Diagnosis, Pelvic Organ Prolapse Distress Inventory, Colorectal-Anal Distress Inventory and Menopause-Specific Quality of Life.
  
  
  RESULTS
  We completed surveys of 1590 women, estimated age 30-59 years, between September 2013 and March 2014. We implemented several strategies to deal with low literacy and used the temporal relationship between marriage and childbirth, and the average age of onset of menarche, to estimate age. Cultural and religious sensitivities and personal security were managed by engaging community leaders, limiting activities to daylight hours, adopting local codes of dress, such as the wearing of head scarves. Our major challenges and experiences included difficulties in age determination, selection of and access to households, interview privacy, lack of basic and health literacy, transportation, political unrest and security of the interviewers.
  
  
  CONCLUSIONS
  By anticipating challenges, we have been able to comprehensively survey a representative sample of Bangladeshi women. Disseminating information about the field challenges and experiences from the BMWHS should assist other researchers planning to conduct surveys about women's health issues in similar context.
authors.affiliation: Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Population Sciences, University of Dhaka, Dhaka 1000, Bangladesh. Electronic address: rakib.islam@monash.edu.
authors.forename: Rakibul M
authors.initials: RM
authors.lastname: Islam
authors.affiliation: Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Bell
authors.affiliation: Department of Population Sciences, University of Dhaka, Dhaka 1000, Bangladesh.
authors.forename: Mohammad B
authors.initials: MB
authors.lastname: Hossain
authors.affiliation: Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Davis
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008593:Menopause; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000473:pathology; D016387:Women's Health
keywords: Bangladesh; Fieldwork challenges; Mid-life women; Population-based survey