Factors enabling women with pelvic organ prolapse to seek surgery at mobile surgical camps in two remote districts in Nepal: a qualitative study.

BACKGROUND Pelvic organ prolapse (POP) is a major reproductive health problem in Nepal, though many women delay seeking treatment. To address this, the Nepalese government has been providing free vaginal hysterectomies with pelvic floor repair to women in mobile surgical camps. Studies exploring factors that enable women to attend these camp settings are limited. This study aimed to identify factors that affected women seeking surgical treatment for POP at mobile surgical camps. METHODS The study used a qualitative approach. Twenty-one women with POP were recruited in two week-long mobile surgical camps held in two remote districts in Nepal during April and May 2013. Data were collected from individual face-to-face interviews and were analysed thematically. RESULTS Three themes and six subthemes emerged from the analysis. The first theme, "health-system factors", suggests that accessibility and affordability of the treatment, and the supportive role of female community health volunteers facilitate women to seek treatment in the camp. The second theme, "factors related to sociocultural norms", reveals that reaching the end of reproductive years and approval by relevant influential family members empowers women to take up surgical treatment in the mobile surgical camp. Similarly, the third theme, "individual-level factors", includes women's experience of POP, such as worsening symptoms and fear of development of cancer, as factors enabling women to seek treatment. CONCLUSION Enablers to seeking treatment at mobile surgical camps for women are related to the Nepalese health system, sociocultural norms and individual experiences of women. Each of these factors should be considered when conducting mobile surgical camps, if women's uptake of treatment is to be enhanced.