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HER Gynecologist Visit @ MS First Factory

Cervical Cancer, Breast Cancer, & Menstruation

Manyasiri (Pear) Chotbunwong

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Demographics: Age

A total of 50 female factory workers attended the session. 92% of participants were of ages lower than 50, which can be explained as 50 is around the age at which women enter menopause. Almost 50% of participants were of ages between 30 and 39 years old, as 30 is the age recommended for women to do HPV examinations.

46% of participants were 30-39 years old. 26% were 21-29 years old. 20% were 40-49 years old. 0% were younger than 20. No teenagers attended the orientation. Based on quantitative data (conversations I had with them), teenage female factory workers believe that they are too young to do the pap smear test or see a gynecologist.

n=50

Survey was conducted on paper. Questionnaire form can be viewed here.

  • Responses

https://docs.google.com/forms/d/e/1FAIpQLSdvyVS4TU0zVLTaiyaIqAJbQIEWfGxHA4hPsxGq1OJyTvoz6g/viewform?usp=sharing

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Demographics: Age

A total of 50 female factory workers attended the session. 92% of participants were of ages lower than 50, which can be explained as 50 is around the age at which women enter menopause. Almost 50% of participants were of ages between 30 and 39 years old, as 30 is the age recommended for women to do HPV examinations.

46% of participants were 30-39 years old. 26% were 21-29 years old. 20% were 40-49 years old. 0% were younger than 20. No teenagers attended the orientation. Based on quantitative data (conversations I had with them), teenage female factory workers believe that they are too young to do the pap smear test or see a gynecologist.

n=50

**Survey was conducted on paper. Questionnaire form can be downloaded here. Digitized form can be viewed here. Responses can be viewed here.

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Demographics: Have you been vaccinated with the HPV vaccine before?

The majority (74%) of female factory workers say that they have not received HPV vaccines and would like the shot(s) if given the opportunity. However, while speaking with the gynecologist, the issue with HPV vaccinations is that they are costly and are not included in the employee’s social security health package. Therefore, factory workers on a daily wage do not have enough money to spend 2,000-3,000 baht on one shot.

Girls under 15 years may receive 2 shots. However, 15-26 years must receive 3 shots, so that would cost around 9,000 baht or 300USD. One factory worker receives a minimum wage of 10USD per day, around 300USD per month. One month’s worth of their salary, working for 8 hrs a day, 5 days a week (160 hrs) is necessary to pay off vaccination bills. Many factory workers also have never heard of HPV vaccines before, as social security doctors usually do not mention it to them, as it requires external payment, which doctors do not want to appear as if they are selling packages to patients if the patient did not inquire about it first.

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Demographics: Have you done a pelvic examination/pap smear test at the factory before?

Half (50%) of our participants have not done the pap smear test, a preliminary test or cervical cancer. From past qualitative observations from conversations I have had with over 50 female factory workers, I learned that women who decide not to undergo the pap smear test are because they are:�1. Scared �2. Uncomfortable with the location (doing a test at a factory instead of a hospital) �3. Believe they are too young �4. Have no issues with their period�This year, however, no pap smear test is provided to factory workers at the factory due to covid restrictions. They can do free pap smear tests at the hospital at which their social security number is connected to, but transportation costs are not paid for - only the test cost.

**Number of women who decide to do the test this year are not (yet) available, otherwise it would be a good indicator of what percentage of women decide to do the test versus not do it last year due to the location of the test

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Baseline: Did you ask the gynecologist any questions/Would you join next year’s orientation?

An overwhelming majority (85%) indicated that they did not raise their hands to ask the gynecologist any specific questions. Reasons may include:

  1. They do not have any issues/questions
  2. Question already asked by another person
  3. Question is too private to ask in a large group setting

Although most participants did not ask the gynecologist any questions, 98% stated that they would like to attend next year’s orientation with the gynecologist again, a great indicator of success. One attendee said, “I want to attend again because I received a lot of knowledge, and I never knew before that cervical cancer vaccines existed”.

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Baseline: Period Problems

Based on the survey, the majority of female participants suffer from irregular periods. They specify that:

  1. Periods don’t come the same time each month.
  2. Periods disappear for 3-4 months or more
  3. Too little/Too much bleeding

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Information/Content

Before attending the event, 94% of participants rated that their understanding of cervical cancer and menstruation was “fair” or “should be improved”.

After attending and listening to the gynecologist, 90% of participants rated their understanding as “good” or “very good”. This was a 1400% increase in number of participants who had a “good” or “very good” understanding from before the event (only 6%) versus after.

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Information/Content

90% of participants state that the event was “informational and useful” or “very information and useful”.

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Gynecologist

90% of participants say that the gynecologist was “knowledgeable” or “very knowledgeable” in cervical cancer and menstruation.

98% of participants said her answers to their questions were “good” or “very good” while 94% said her overall presentation was “good” or “very good”.

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Others

Almost 90% (87.8%) of participants indicated that the location of the orientation was “good” or “very good”. Around 85% indicated that the length/timing of the event was “good” or “very good”

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Most useful information you learn?

Most common answers are:

  1. Cervical and Breast Cancer: Risk Assessment, Self-Diagnosis, Prevention, & Treatment
  2. Cervical Cancer/HPV Vaccination
  3. Pelvic Examinations: Method, How Often, and Benefits

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How would you improve the event?

Most common answers are:

  1. Increase time allocated for event to absorb more information
  2. Presentation Materials - computers, slides, etc. (there were technical difficulties before the event)
  3. Increase density of information/content

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Lingering Questions for Gynecologist

In the survey, I asked if anyone had lingering questions for the gynecologist, as only 15% of participants raised their hands to ask anything.

Most said they do not have further questions. Those who did have them asked:

I have pelvic inflammation and am currently pregnant. I want to know if HPV is life-threatening to child in the womb?

If I haven’t done HPV exams for a very long time, are there any implications?