Dilşad Save

Prevalence of type 1 diabetes mellitus in 6–18-yr-old school children living in Istanbul, Turkey

Akesen E, Turan S, Güran T, Atay Z, Save D, Bereket A. Prevalence of type 1 diabetes mellitus in 6–18‐yr‐old school children living in Istanbul, Turkey.

Do perceived health risks outweigh the benefits of modern contraceptives? A qualitative study in a suburban population in Istanbul, Turkey

Objectives To evaluate the health concerns and the perceived non-contraceptive benefits of modern contraceptive methods through utilizing qualitative methods. Methods Six focus group discussions were carried out with a total of 53 married women in a socio-economically disadvantaged community in Istanbul, Turkey. Results Women had a vague knowledge of the mechanism of menstruation. Some women believed that the uterus was filled with blood—termed ‘dirty blood’—which should be eliminated during menstruation in order to stay healthy. For this reason, amenorrhoea was recognized as the important disadvantage of the progestin-only injectable contraceptives. While the participants mentioned fallacious and exaggerated side effects related to modern methods they did not recognize their non-contraceptive benefits. Most women gained the information concerning side effects through their social networks. Sometimes the information acquired was based on rumours that biased women against the modern contraceptives. Conclusions Women outweighed the risks, some of which were fallacious and exaggerated, against the benefits of modern contraceptives. It is crucial to address health concerns of women and what they ‘heard’ from their peers during counselling sessions. Also the non-contraceptive health benefits of modern methods should be well emphasized. Since informal sources are prevalent, the effectiveness of peer education should be studied in this community.

Knowledge of oral cancer, preventive attitudes, and behaviors of primary care physicians in Turkey.

Oral cancers (OCs) have a high mortality rate because of their typically late diagnosis. Primary care physicians play a vital role in early detection. In this study, we evaluated the family physicians’ (FPs) knowledge, preventive attitudes, and behaviors in terms of OCs. A semistructured questionnaire consisting of 50 questions was prepared and distributed to 200 FPs. Questions were grouped under four main headings: demographic characteristics, general protective attitudes against OCs, risk factors, and daily practices while performing the necessary examinations and referrals. Of 200 FPs, 164 responded to the questionnaire (82% response rate). The mean age of the study participants was 34.8±8.4 years and the mean duration of practice was 10±8.1 years. One-third of the physicians (29.9%, n=49) stated that they did not inquire about the amount of tobacco use. In terms of alcohol use, 45.7% (n=75) and 56.7% (n=93) did not ask about past alcohol consumption or the amount of alcohol consumed, respectively. Moreover, 69.5% (n=114) believed that they did not receive adequate smoking cessation training and 79.9% (n=131) stated that they did not receive any alcohol cessation training. To decrease morbidity and mortality associated with OCs, primary care physicians should be trained to ask their patients about high-risk behaviors, provide counseling and education on tobacco and alcohol-abuse cessation, and provide oral examinations.

The influence of gender roles on health seeking behaviour during pregnancy in Turkey

Objectives To explore the impact of gender roles in relation to health seeking behaviour during pregnancy and childbirth. Methods The study was conducted in neighbourhoods with low antenatal care rates in three provinces of Turkey. The study population consisted of pregnant women who never got or discontinued antenatal care and their peers, families and community leaders. Sixteen focus group discussions and 125 in-depth interviews were conducted with a total of 239 participants. Results Pregnancy and childbirth are interwoven strongly with gender roles. Since the patriarchal system acknowledges women through the means of childbirth, women are expected to have many children. Hence women experience pregnancy as a burden and are not motivated to seek antenatal care. During pregnancy, only ‘serious’ conditions are considered as legitimate reasons for accessing care. However, the decision regarding whether a pregnant woman is seriously sick or not belongs to the responsibilities of elder women, which delays service use. Conclusions Providing information regarding the value of antenatal care also to elder women is essential in increasing the demand to the services. Incorporating gender perspectives into daily health practice and maintaining access to high quality reproductive care services are vital in reducing the gender based barriers to care.