Study of Women's Reproductive Health Knowledge, Awareness, and Attitudes in Borgaon Village, Wardha, India

Background: Reproductive health is defined as a state of complete physical, psychological, and social contentment, free of sickness, as well as the functions and activities of the reproductive system..As many women in India are unaware of the sexual health and its comorbidities they end up falling in serious illness leading to various life threatening diseases. Aim: The aim was to study about knowledge, awareness and attitude towards reproductive health of women in Borgaon Village of Wardha,India. Methodology: This is a descriptive cross-sectional study conducted at Borgaon village of Wardha district Maharashtra India. Total 100 women aged 20 to 45 were selected by simple random sampling method was enrolled in study after verbal consent . Women were contacted and interviewed with a semi structured questionnaire.The study was conducted in 6 months duration with the help of questionnaire. Results: As per the statistics, 78percent women use sanitary pads though 55percent women were still using napkins & cottons due to lack of awareness, shyness & low economic condition. 82percent women were aware about contraception but still 59percent women preferred to use it, Original Research Article Tarare and Chaple; JPRI, 33(60B): 2589-2601, 2021; Article no.JPRI.71281 2590 because they were worried about its side effects. It was found that, when women came across any gynecological problem only 67percent of them had quick approach to doctor. 76percent women thought about the need of learning reproductive knowledge. Conclusion: It was concluded that we still need to aware the society about reproductive health of women because whole society should be well known about the measures to be taken and how to act wisely to deal with a woman suffering from any illness regarding reproductive health.


INTRODUCTION
Reproductive health is defined as a state of complete physical, psychological, and social contentment, free of sickness, as well as the functions and activities of the reproductive system. Sexual and reproductive health care, which includes HIV/AIDS, includes the prevention and treatment of sexually transmitted diseases (STDs). The reproductive health care system aids in the right diagnosis, treatment, and management of illness urgent conditions.
According to the World Health Organization (2017), period after childhood and before adulthood is known as adolescence. Human growth and development occur around 10 to 19 years of age. The adolescence is further classified into three phases that are early 10 to 13years of age, mid 14 to15years of age & late i.e.14 to 19years of age. Somatic and mental development of girl for safe motherhood is nothing but the period of adolescence. Overall adolescent health is covered under reproductive health [1].
From past few years it is noticed that the effect of occupational exposure on women's reproductive health is great. Earlier studies only focused on health of fetus instead of reproductive health of women. But now, it is found that reproductive toxins lead to hormonal imbalance resulting in disturbed menstrual cycle, ovulation and fertility rate of women. So, the attention is shifted towards occupational health hazards among pregnant women and fetus [2].
Stress is one of the major issues in the society and it is always found that women are highly exposed to mental, physical as well as physiological stress. Mental i.e. psychological stress has great impact on reproductive health of women. Because stress produces the generation of ROS means Reactive Oxygen Species and leads to oxidative stress (OS). This oxidative stress affects health of ovary, quality of oocytes and ultimately results in disorders of reproductive health of women. Shatavari i.e. Asparagus racemosus is widely prescribed ayurvedic medication to tackle stress induced reproductive health disorders.Shatavari is known as rasayana drug and also counts in major health tonics [3].
Menstruation is the unique concept in women. Beginning of menstruation is noticeable changes occur in girl during her adolescent years. Still menstruation is considered as something dirty and unclean in our society. Ultimately respond towards menstruation is depends upon the knowledge and the awareness of the people. Though the menstruation is purely a natural process some misconceptions leads to adverse health outcomes. During menstruation maintaining hygiene is very important factor because it results into reproductive tract infection (RTI). Now a days many women are suffering from various types of RTI and its complications. Also, many pregnant mothers transmitted it to their offspring due to lack of knowledge [4].
Socio economic status and education both are very crucial factors to determine women's health. Rather focusing only on disease, it is very important to reported and realized these factors which influences reproductive health consequences and women's health seeking behavior at community level [5].
Menstruating girls feels shame, fear and confusion in school due to gender discriminatory nature of teachers, so they are unable to handle the protection, dignity and privacy of their menstruation. Due to lack of sufficient information, lack of social support, shortage of facilities for water & waste disposal girls is facing many challenges during their menstruation. Columbia University and United Nations Children's Fund (UNICEF) organized the "Menstrual Hygiene Management in Ten" in New York in October 2014 for 10 years to overcoming barriers facing by school going girls [6].
Nearly any one is conscious of the extremely bad reproductive health situation in women. The needs for reproductive health care are broad. Nevertheless, development of reproductive health care is not a trouble-free objective in society. Perspective which is widely accepted and socially integrated is very important for any inculcative initiative in the reproductive health care zone. The perspective should have a better way of understanding the current place of women in society and what they really deserve and desire [7].
Physiological fact which is naturally occur in adolescent girl and premenopausal women is called as menstruation. Sanitary products used by women and adolescent girls to collect the blood during menstruation which can be changed in privacy according to need is nothing but menstrual hygiene management. It also includes washing the body with help of water & soap, and proper disposal menstrual management material [8].
School going girls age between 16 to 20 years from south Africa are found to affected with sexually transmitted diseases, HIV and teenage pregnancy. Study shows that women suffering from HIV are four times that of men of same age. Not seeking proper care let them untreated which ultimately lead to pelvic inflammatory diseases i.e. PID and high risk of ectopic pregnancy. Early pregnancy hampers their schooling, proper employment and earning sources.
In the last few years, it is found that incorrect social and behavioral factors lead to dangerous reproductive health outcomes. Due to lack of parental care and low economic condition young women are suffering from many reproductive health issues. Relationship play important role in maintaining proper reproductive health. Problems such as HIV positive partner, difference in age among sexual partners i.e. with a male partner who is older, multiple partners are more prone to disorders of reproductive system [9].
Intimated partner violence affects mental as well as physical health of women leads to multiple abortions, accidental pregnancy and reduce sexual autonomy. Intimated partners violence leads victim to impaired lifestyle. Anxiety and depression are found to be very common in women suffering from intimated partner violence. There is great impact of violence on pregnant women. There may be risk of neonatal death, pre-term delivery, low birth weight of infants as well as affected breast feeding. Gynecologists noticed that patients are not easily disclosing intimated partner violence and avoid to take treatment for the same. Educating and empowering women can help them to overcome violence. Improving their social and economic status is needful. There is need to protect women from intimated partner violence [10].
Girls and women having low income are less aware about hygienic practices & lack of suitable materials use for menstrual hygiene management.
Menstruation is usually surrounded by shame, silence as well as social prohibition. In religious countries it is found that normal activities and freedom is restricted due to menstruation. Such as, cooking food, performing religious rituals, interacting with people, drinking milk, etc limitations found in many cultures [11].
Assessment of the awareness regarding reproductive health among women in the rural population and to study their attitudes towards reproductive health is the main motto of the study. Because in India, there is insufficiency of such type of studies, mainly in rural areas. Organizing health education programs and providing health care facilities will improve their reproductive health. We can help women by providing them with educationists, policy makers and health care workers.

Study Design
Descriptive Cross-sectional study was undertaken in the community. Based on a wellstructured questionnaire, personal interviews with women aged 20 to 45 were conducted. Personal interviews were conducted in the Wardha District's Borgaon Village. Questionnaires administered by an interviewer were used to assess socio-demographic characteristics, knowledge, and awareness of reproductive health in women. Before data collection attempt.

Study Setting
Study was conducted in Borgaon Village of Wardha, India. As many patients were visiting OPD of AVBRH Sawangi Meghe with reproductive complaints and the village is adapted by our institute we found it right to choose Borgaon as a place of study.

Study Type
Cross sectional Observational study.

Inclusion Criteria
Women between the ages of 20 years and 45 years are included.

Exclusion Criteria
Women below the age of 20 years and over the age of 45 years are exempt. Women those who didn't give consent for questionnaire.

Strength and Limitation
Its cost effective and the participants are more willing to paricipate in the study and it is limited to age group of 20 -45 years of age women. The study is limited to residentials of village Borgaon Wardha district.

OBSERVATIONS AND RESULTS
Observation is noted and presented in the form of charts. During the survey, 100 women aged 20 to 45 years were interviewed, and their responses were collected.  Do you know about itching in genitalia? 79 21  Chart 2. Shows that 35percent of women were using cloths due to low economic condition. 31percent women were using it due to difficulty with disposal. It is found that due to lack of awareness 38percent of women were using cloths. 32percent of women were using cloths because of their personal preferences. 43percent of women were using cloths due to shyness to buy & 21percent of women were facing problems like unavailability of shop in their locality.
It is found that 83 percent of women were responded that knowledge of contraception is necessary. 5percent of women thought that there is no need of contraceptive knowledge. 12percent of women responded may be.
Chart 3. Shows that 73percent women were thought that male condom is suitable contraceptive. Only 24percent women were responded to female condom. 29percent women were thought that intrauterine devices are the best. 35percent of women go for oral contraceptive pills. 38percent women were preferred not to say.

DISCUSSION
This study shows that menstruating women ranged in age from 12 to 19 years, whereas Hatwar, V.'s study revealed that the menstruating girls ranged in age from 12 to 16 years [12].
In this study, it is found that 73percent women were thought that male condom is suitable contraceptive. Only 24percent women were responded to female condom. 29percent women were thought that intrauterine devices are the best. 35percent of women go for oral contraceptive pills. 38percent women were preferred not to say. An equivalent study done by Simbar, M. reveals that only 48percent of participants were using condoms [13].
In this study it is stated that 76percent women thought that there is need of learning reproductive knowledge. Still 8 percent of women thought that there is no need of learning reproductive knowledge. 16percent of women responded may be.Study done by Simbar, M. shows that majority of study subjects believed that awareness of reproductive health is beneficial, but they thought that programmes were insufficient [13].
In this study, it is reported that 78 percent women were use sanitary pads though 55percent women were still used napkins & cottons due to lack of awareness, shyness & low economic condition& 4percent of women were using tampons. Not a single woman was known about toilet paper, similar study by Nagaraj showed that only 26.3percent of study subjects were using sanitary pads. This difference might be due to better awareness & availability of sanitary pads in their respective areas [14].
This study shows that 30percent women got knowledge of contraception from newspaper. According to 47percent women electronics media were good source. It is found that women from village got their maximum knowledge from family & friends due to lack of exposure. 49percent of women responded that their source of knowledge were doctors. Similar study conducted by Abajobir observed that the source of knowledge was health practitioners for reproductive health [15].
In this study 31percent of women were thought that occasionally, sex does not lead to pregnancy. 21percent of women were thought that contraceptive strategies are too costly to purchase. 22percent of women were worried about side effects. 28percent women responded that their spouses do not want contraception to be used. 26percent of women were responded that contraceptives are inconvenient to buy. 22percent of women don't even know the method to use the contraceptives.Similarly study 67 20 13 Quick approach to doctor Self management Ignore the problem conducted in east gojjam zone by abajobir, rural adolescents noticed that poor knowledge and peer pressure, husband opposition prevented participants from accessing contraceptive methods [15].

CONCLUSION
Sexual health is as important as any other facet of health and should receive the same level of attention. It was concluded that we still need to aware the society about reproductive health of women because whole society should be well known about the measures to be taken and how to act wisely to deal with a woman suffering from any illness regarding reproductive health. Along with personal hygiene, proper disposal of absorbent used is also important. Each of the aforementioned areas offer steps in pathways for expanding the existing literature works and steps to improve sexual health of women.

RECOMMENDATIONS
Special health drives and awareness regarding sexual health should be started. Despite of sexual health as a vital sign for overall health and well being and should be regarded with importance similar to other aspects of health. Health education is an important factor in improving awareness and practices related to menstruation. Therefore, a properly planned health education needs to be provided to all adolescent girls and women by governmental and non-governmental organizations. In order to crack social inhibitors and empower young teenage girls with proper awareness, all women need to be informed about menstruation and menstrual hygiene practices. It is also essential to involve lady teachers in schools for sustained health awareness programs in schools.

NOTE
The study highlights the efficacy of "Ayurveda" which is an ancient tradition, used in some parts of India. This ancient concept should be carefully evaluated in the light of modern medical science and can be utilized partially if found suitable. At the heart of each of the above tables and charts mentioned above the continuously emerging reviews and discussions of this topic lies an increasing understanding of the importance of taking seriously the emotions, meanings, preferences, and lack of knowledge reported and experienced by women in various social demographic groups and at various places of local villages proved useful.

CONSENT
Verbal consent was taken from the study participants