Bringing Down Hurdles for Female Genital Schistosomiasis Access to Care: A Multi-Country Socio-Structural Integrated Approach to Developing A Community-Based Teaching Platform
Female genital schistosomiasis (FGS) affects over 45 million women worldwide and mostly in sub-Saharan Africa. It is possibly the most underestimated gynaecological condition caused by the parasitic worm Schistosoma haematobium.
What is Female Genital Schistosomiasis?
Female Genital Schistosomiasis (FGS) is a disease condition caused by the presence of eggs of Schistosomiasis in women’s reproductive organs. If women have FGS for a long time without being treated, the eggs laid by the adult parasite migrate and become trapped in genital organs such as fallopian tubes, ureter, cervix and vagina.
FGS is associated with infertility, dyspareunia and symptoms mimicking sexually transmitted infections (STIs), is a risk factor for HIV transmission and is associated with human papillomavirus (HPV) and cervical cancer. However, FGS diagnosis is challenged by the need for costly equipment and high-level specialized training, low awareness of the disease, symptoms that could indicate other conditions (including STIs) and stigma associated with sexual transmission.
The aim of the project is to see if female genital schistosomiasis (FGS) screening can be successfully promoted through a community-based teaching intervention that addresses socio-structural barriers (including stigma) and links to broader sexual and reproductive health (SRH) prevention services. This will be developed and piloted across three African countries, namely Malawi, Tanzania and Zambia, and in one site in each country. The three African institutions are: Blantyre Institute for Community Outreach (BICO), Malawi; Catholic Institute for Health and Allied Sciences/ Bugando Medical Centre, Mwanza; Zambart, Zambia.
In Zambia, the study is being conducted in Shikoswe, in Kafue District.
Recently completed a Broad Brush Survey (BBS) qualitative fieldwork, in each country led by a social scientist in the selected communities. The following activities were conducted: spiral walk of places of relevance in the community; structured observations of daily activities of women and girls linked to water sources and household sanitation, gathering places and health services; focus group discussions (FGDs) and key-informant interviews with elderly women, women of child bearing age, adolescent girls, health workers and key opinion leaders.
Rapid analysis of BBS data and the development of community education materials are underway.
Life cycle of Schistosomiasis