Exploring explanatory models of women's reproductive health in rural Bangladesh

This study illustrates the use of systematic elicitation techniques for cultural domain analysis, including free listing, pile sorting and severity ratings to identify salient illness categories and perceptions of illness severity among rural Bangladeshi women. The complementary strategies of in-depth interviewing and collecting of case studies were also employed for delineating explanatory models. Illnesses in the domain of women's reproductive health-for example, reproductive tract infections (RTI)-were found to be among the most salient and serious health problems for which care is sought. Data gathered through pile sorting demonstrate that women in this rural community have clear conceptions of illness groups, with different strategies of treatment for various categories. While concerns relating to reproductive tract infections, including those attributed to sexual transmission, and vaginal discharge are important to women, none of the available health facilities is particularly attuned to addressing these needs. Developing health care services taking women's explanatory models into consideration could be of importance for reducing the spread of RTI and sexually transmitted/HIV infection in rural Bangladesh.