Adhikari Dushala, Bhurtyal Ashok
MPH student, Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal. Correspondence:
Assistant Professor, Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Sex Reprod Health Matters. 2021;29(2):2141255. doi: 10.1080/26410397.2022.2141255.
Health care needs of menopausal women and availability of corresponding services through health systems are under-researched. This two-stage observational study examined the prevalence of menopausal symptoms among middle-aged women in four rural and semi-urban communities in Kavrepalanchok, Nepal and explored sexual and reproductive health (SRH) care providers' readiness to provide menopausal health care. We recruited 252 women aged 40-59 years in the pre-, peri- and post-menopausal phases of the menopausal transition, and interviewed 20 SRH primary care providers. The cross-sectional survey provided data on the prevalence of menopausal symptoms, disaggregated by women's socioeconomic characteristics, health behaviours and biological features, while data on the knowledge, skills and willingness of SRH care providers to deliver menopausal care were derived from interviews. Most women (84.9%) reported experiencing one or more adverse menopausal symptoms. Socioeconomically and geographically marginalised women were more likely to report experiencing severe menopausal symptoms that would require medical assistance than their more privileged counterparts. Sexual and reproductive health service providers were willing, albeit with limited knowledge and skills, to assess menopausal women's needs and provide menopausal care. They recommended incorporating menopausal care in SRH policies and training and logistics to provide the services. Culturally, economically and geographically marginalised women experienced a higher prevalence of menopausal symptoms. Sexual and reproductive health policies and programmes of the government should expand beyond women of childbearing age or adolescents to include menopausal women's needs.
更年期女性的医疗保健需求以及通过卫生系统提供相应服务的情况尚未得到充分研究。这项两阶段观察性研究调查了尼泊尔卡夫雷巴兰乔克四个农村和半城市社区中年女性更年期症状的患病率，并探讨了性与生殖健康（SRH）护理提供者提供更年期保健服务的意愿。我们招募了处于更年期过渡前期、围绝经期和绝经后期的252名40 - 59岁女性，并采访了20名SRH初级护理提供者。横断面调查提供了按女性社会经济特征、健康行为和生物学特征分类的更年期症状患病率数据，而SRH护理提供者提供更年期护理的知识、技能和意愿数据则来自访谈。大多数女性（84.9%）报告经历过一种或多种不良更年期症状。社会经济和地理上处于边缘地位的女性比条件更优越的女性更有可能报告经历需要医疗援助的严重更年期症状。性与生殖健康服务提供者愿意评估更年期女性的需求并提供更年期护理，尽管他们的知识和技能有限。他们建议将更年期护理纳入SRH政策以及提供服务所需的培训和后勤保障中。在文化、经济和地理上处于边缘地位的女性更年期症状患病率更高。政府的性与生殖健康政策和项目应超越育龄妇女或青少年，纳入更年期女性的需求。
