Rural-urban correlates of reproductive health with mental health in women in Odisha, India

Abstract

Background: Mental health and reproductive health are closely related. Women of reproductive age are most vulnerable. Odisha has poor maternal health indicators. Very few Indian studies comparing urban-rural differences in women’s mental health. Methods: Random sampling from respective field practice areas. GHQ-12 Mental Health screening tool used to assess health status. Pre-tested questionnaire applied to enquire about domestic and familial status, reproductive health morbidities. Results: Proportion of reported extramarital relationships of the respondents’ husband was observed to be more than twice as much in urban as compared to rural areas. Prevalence of domestic violence was found to be 43.2% in urban area as compared to 27.2% in rural areas. Significant differences were seen between urban and rural arms of the study regarding adverse pregnancy outcomes (p<0.001), induced abortion (p<0.0001), menstrual problems (p<0.0004) and gynaecological problems (p=0.0031). In these cases, rural women were observed to have significantly more combined (reproductive and mental health) morbidity than their urban counterparts. Conclusions: Findings of the study indicate that though familial and spousal and social support parameters were more adverse in urban women, reproductive health problems and their association with poor mental health was strikingly more common in the rural populace. This may indicate an erosion of the traditional buffers against adverse mental health outcomes in the rural setting and needs further investigation.