Opinion of Doctors on Discrimination of Female Patients Suffering from Hepatitis C During Pregnancy at Public and Private Hospitals of Islamabad

Addul Naeem, Fozia Rashid, Shagufta Faisal, Waheed Majeed, Ramza Rukia, Shabana Saleem
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Abstract

Background: Hepatitis C is viral disease that affects the liver in humans; globally it is very prevalent disease and a frequent cause of death. This study explored the HCV screening pattern during pregnancy and to establish national guidelines for HCV screening in the light of international guidelines during pregnancy based on suggestions of experts. Methods: A mix method cross sectional survey was conducted including gynecologist and obstetricians professionals working in the different government and private medical institutions. Sixty-four professionals were selected for quantitative part while fifteen were selected for the qualitative part. In dept interviews were conducted and using a questionnaire quantitative data was collected. Data was presented in the narrations, graphs and tables. Frequencies and proportions were calculated. Results: Among the study participants 85.9% experts agreed that we can follow international guidelines for HCV screening in our settings. The majority of the experts provided that National screening guidelines should be based on risk factor based. It was observed by the expert opinion that there is social and mental stigma among the pregnant females positive for HCV i.e. Feel badly labeled 73.4%, Discrimination during antenatal visits 29.7%, Discrimination during delivery 56.2%, Not sure about breast feeding 81.2%, Problem facing during baby care 50%, Personal relationship problems 65.6%, Problems at family level 59.3%, Social discrimination 73.4%, Mental stress 79.6% and Discrimination at job/work place 48.4%. Study participants provided that universal screening during pregnancy is necessary because of the various reasons including safety of the health care providers and to aware the health care providers about the safety measures during handling of a HCV positive case, Prevent the vertical transmission and it will provided the estimate about the HCV burden among the population especially among the pregnant population. Conclusion: Study concluded that there is social and mental stigma among the pregnant females positive for HCV.
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医生对伊斯兰堡公立和私立医院歧视女性妊娠期丙型肝炎患者的意见
背景:丙型肝炎是影响人类肝脏的病毒性疾病;在全球范围内,这是一种非常普遍的疾病,也是常见的死亡原因。本研究在专家建议的基础上,探讨妊娠期HCV筛查模式,参照国际妊娠期HCV筛查指南,制定国家HCV筛查指南。方法:采用混合方法进行横断面调查,调查对象为在不同的政府和私营医疗机构工作的妇产科专业人员。定量部分选择64名专业人员,定性部分选择15名专业人员。在深入访谈和使用问卷定量数据收集。数据以叙述、图表和表格的形式呈现。计算频率和比例。结果:在研究参与者中,85.9%的专家同意我们可以在我们的环境中遵循HCV筛查的国际指南。大多数专家认为,国家筛查指南应以风险因素为基础。专家意见认为,HCV阳性孕妇存在社会和心理污名,即感觉被贴上不良标签73.4%、产前检查歧视29.7%、分娩歧视56.2%、不确定母乳喂养81.2%、婴儿护理面临问题50%、个人关系问题65.6%、家庭问题59.3%、社会歧视73.4%、精神压力79.6%、工作/工作场所歧视48.4%。研究参与者表示,由于各种原因,包括卫生保健提供者的安全,以及卫生保健提供者在处理HCV阳性病例时的安全措施,预防垂直传播,在怀孕期间进行普遍筛查是必要的,这将提供人群中特别是怀孕人群中HCV负担的估计。结论:HCV阳性孕妇存在社会污名和心理污名。
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