Nomadic Tibetan women\u2019s reproductive health: findings from cross-sectional surveys with a hard-to-reach population

Tabashir Z. Nobari,Kunchok Gyaltsen,Lhusham Gyal,Lumo Tsering,Corrina Moucheraud,Jessica D. Gipson

doi:10.1186/s12978-020-01052-0

Abstract

BackgroundWestern China has undergone substantial sociodemographic change, yet little is known about the health status of ethnic minority populations living in these areas.MethodsWe report findings from two cross-sectional surveys conducted with female Tibetan nomads living in rural areas of Western China/Eastern Tibet. We present results of descriptive analyses of data collected from reproductive-aged females who attended community health fairs in 2014 (n = 193) and 2016 (n = 298).ResultsOn average, sexual debut preceded marriage among study participants, with fertility near replacement levels (2.7 and 2.1 in 2014 and 2016, respectively). Contraceptive use was common, and dominated by use of IUDs and female sterilization. Although over three-quarters (76%) of 2016 survey participants reported ever having at least one sexually transmitted infection (STI) symptom, there was low awareness of STIs (59%) and action to prevent STIs (21%). Younger women (< 40) were more likely to report having had had an STI symptom, as compared to older women (84% versus 71%; p < 0.05).ConclusionsWe demonstrate feasibility of collecting data with this hard-to-reach population. Reporting of STI symptoms warrants further investigation to identify and address health conditions in this population of Tibetan nomadic women, especially amidst broader social and contextual changes that may affect the Tibetan population.

Highlights

Western China has historically been home to a large number of ethnic minority residents, but has undergone substantial economic and social change in the past two decades [1, 2]
Western China has undergone substantial sociodemographic change, yet little is known about the health status of ethnic minority populations living in these areas
We report findings from two cross-sectional surveys conducted with female Tibetan nomads living in rural areas of Western China/Eastern Tibet

Summary

Introduction

Western China has historically been home to a large number of ethnic minority residents, but has undergone substantial economic and social change in the past two decades [1, 2]. Government initiatives have prompted economic development in Western China, including the expansion of private industry, leading to an influx of Han (ethnic majority) Chinese into the more rural areas of China and the Tibetan plateau [1, 2] In addition to these development efforts, policies that promote the settlement of Tibetan populations into urban areas have substantially altered the cultural context of Western China. Ethnic minority populations may face unique barriers, including communication with health professionals at Chinese health care facilities and discriminatory treatment [12] Evidence suggests that these nomadic groups may even experience differential treatment by other Tibetans [13]. Western China has undergone substantial sociodemographic change, yet little is known about the health status of ethnic minority populations living in these areas

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