Background and conceptual framework

Although, over the last decade, several studies have highlighted the widespread prevalence of reproductive tract infections and other gynaecological morbidities within community settings, few have explored the social context of gynaecological morbidity: its behavioural antecedents; the consequences of morbidity for women's lives; and/or women's health seeking patterns surrounding it. The objective of this paper is to shed light on what is known on each of these issues and to suggest a set of research questions to be explored in subsequent studies on the behavioural context of gynaecological morbidity.

A review of available evidence reveals that our understanding of the range and importance of the determinants of gynaecological morbidity – biomedical, behavioural, environmental and iatrogenic – remains at a very rudimentary stage. The roles of potentially key determinants, ranging from sexual behaviour and practice and iatrogenic factors, to behavioural norms for women and men, to misperceptions regarding healthy practices, to constraints on women's access to information and services, and the role of male partners, are undoubtedly difficult to research.

Studies conducted thus far also collectively shed relatively little light on the ways in which women seek treatment for gynaecological problems, or on the consequences and implications of gynaecological morbidity for women's daily lives. Little is known about whether women seek treatment, what types of care are sought and, in particular, the actual or perceived barriers faced by women in seeking care. Similarly, little is known about how such morbidity affects women's ability to fulfil a diverse and wide range of expected roles – economic productivity, domestic responsibilities, marital and sexual relationships – as well as their own psychological well-being