Women In Fiji Research Articles

Prevalence and trends of cervical cancer screening among women in Fiji from 2014 to 2018

IntroductionCervical cancer is the third most common cancer in women both in developed and developing countries. This study aimed to determine the prevalence of cervical cancer and the trends of cervical cancer screening among women who had cervical cancer screening in Suva, Fiji between 2014 and 2018. Materials and methodThis study applied a 5-year retrospective electronic chart review of data from all women attending the Women's Wellness Clinic (WWC) in Suva, Fiji. The women who were selected for this study and screened for cervical cancer were Fijian citizens above 18 years of age and were registered in 2014–2018. A data collection form was used to collect data. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 24; p <0.05 % was considered as the level of significance. ResultsAmong the 39,579 women who attended WWC for other family planning services, 12,074 women screened for cervical cancer with a prevalence of 30.5 %. The overall mean age for women screened for cervical cancer was 37.6 (SD ± 11.2). Two-thirds (76.4 %) of the women screened for cervical cancer were less than 46 years of age and 53.9 % were I-taukei. The number of women who came for Pap smear increased in 2015, however, a slight decline was observed in 2016 which was later improved to 35.1 % in 2018. Malignancy was more common in the age range of 42–49 respectively. In this study, women of 46 years and above had an OR of 0.51 (95 % CI: 0.36, 0.72), other ethnicity OR was 1.73 (95 % CI: 1.27, 2.35), and the Muslim religion OR recorded was 1.44 (95 % CI: 1.03, 2.01) which was comparatively considered a high-risk group. Women who are widowed 1.57 (95 % CI: 0.798, 3.11), single 1.29 (95 % CI: 0.87, 1.92) or divorced 1.08 (95 % CI: 0.59, 1.99), employed 1.01 (95 % CI: 0.83, 1.24) and are living in rural areas 1.19 (95 % CI: 0.82, 1.73) are also associated with higher odds of having abnormal results. ConclusionCervical cancer is listed as the first and most common type of cancer in women which is noticeably increasing in Fiji. Even though cervical cancer screening has improved over the years, adequate surveillance systems and ongoing programs should be designed and implemented to increase awareness and monitor the trend of cervical cancer screening in order to reduce cervical cancer prevalence and mortality rates.

“People are now working together for a common good”: The effect on social capital of participatory design for community-level sanitation infrastructure in urban informal settlements

Communities with higher levels of social capital perform better than communities with lower social capital in community-level water and sanitation interventions and have better health outcomes. Although research recommends bolstering social capital to improve intervention outcomes, few studies provide empirical evidence on the effect of intervention activities on social capital. This study aimed to evaluate the effect of participatory design and community engagement activities on social capital among urban informal settlements in Suva, Fiji and Makassar, Indonesia enrolled in the Revitalizing Informal Settlements and their Environments trial using the Short Adapted Social Capital Assessment Tool. We performed confirmatory factor analyses (CFA) to test tool performance and built structural equation models to assess intervention effect on CFA-informed, sub-scale scores for cognitive and structural social capital. Qualitative in-depth interviews in Fiji and Indonesia and focus group discussions in Fiji provided nuanced understanding of intervention effects on social capital from residents’ perspectives. Results confirmed the hypothesized two-factor solution but revealed differences by country and by gender in Indonesia. The intervention appeared positively related to cognitive social capital among men and women in Indonesia and negatively related to cognitive and structural social capital among men and women in Fiji. While effect sizes were small and cluster-adjustment for a small number of settlements yielded non-significant effects, trends were consistent across models and bivariate analyses and were corroborated by qualitative findings. Several contextual factors may explain these results, including timing and duration of intervention activities and influence of COVID-19. Qualitative data suggested that the relationship between participatory design and social capital may be bidirectional, helping to explain why certain settlements appeared to be better equipped to benefit from intervention activities. Practitioners and program designers should carefully consider the social pre-conditions of communities in which they intend to work to optimize program outcomes and avoid unintended consequences.

Ethnic disparity in cancer mortality in adult Fijian women, 2013-17

Abstract Background Fiji, population 884,887 (2017 census), is a Pacific Island country with two dominant ethnic groups: 62% Indigenous Fijians (i-Taukei) and 31% Fijians of Indian descent (FID). Cancer mortality by ethnicity for women aged 30-69 years was investigated. Methods Proportional mortality and probability of dying (PoD30-70) from cancer (ICD-10: C00-D48) for women aged 30-69 years were calculated from empirical unit mortality data by ethnicity. PoD30-70 is the cumulative mortality risk derived from the cumulative rate, from mortality rates by 5-year age group. Results Cancer was reported as the underlying cause in 21% of deaths of Fijian women aged 30-69 years; 25% for i-Taukei and 14% for FID women. This ethnic disparity was consistent across cancer sites, including breast, cervical/uterine and ovarian cancers. Empirically derived PoD30-70 from all cancers (ICD-10 C00-D48) was 9.6% (95%CI: 9.1-10.1%) for Fijian women; higher for i-Taukei (12.1%; 95%CI: 11.4-12.8%) than FID women (6.6%; 95%CI: 5.9-7.2%). Globocan 2020 estimates the highest PoD30-70 from all cancers in women was 10.8% in Malawi; for Fiji, Globocan estimates of 9.2%, from 2008-2012 mortality rates applied to the 2020 population, are comparable to empirically derived PoD30-70. From empirical data, PoD30-70 from breast cancer for Fijian women was 2.9% (95%CI: 2.6-3.1%), higher in i-Taukei (3.8%; 95%CI: 3.4-4.2%) and lower in FID women (1.7%; 95%CI: 1.4-2.1%). Globocan 2020 estimates of PoD30-70 due to breast cancer was highest in Barbados (3.6%), followed by Fiji (3.4%). PoD30-70 due to cervical/uterine and ovarian cancer was approximately double for i-Taukei (3·2 and 1·0%) compared to FID women (1·5 and 0·5%). Conclusions PoD30-70 due to breast cancer and all cancers was higher in i-Taukei Fijian women than in other countries and was double that of FID women. High incidence and late diagnosis contribute to high cancer mortality; differences between i-Taukei and FID women require further investigation. Key messages • Probability of dying due to breast cancer, and all cancers, was higher for i-Taukei women in Fiji than for women in other countries, and double that of Fijian women of Indian descent. • High incidence and late diagnosis contribute to high cancer mortality; further investigation is required to determine how these, and other potential factors, contribute to ethnic differences.

Rapid review of factors influencing dietary behaviors in Fiji.

In Fiji, multiple burdens of malnutrition including undernutrition, overweight/obesity, and micronutrient deficiencies coexist at the individual, household, and population levels. The diets of children, adolescents, and adults are generally unhealthy. The objective of this review was to understand how the dietary behaviors of children, adolescents, and women in Fiji are influenced by individual, social, and food environment factors. This rapid review was conducted to synthesize existing evidence, identify research gaps in the evidence base, and make recommendations for future research. The Cochrane Rapid Reviews Methods and the updated guideline for reporting systematic reviews were used. The search strategy for this rapid review was based on the Population Context Outcome [P(E)CO] framework, including search terms for population (children, adolescents, and adults), context (Fiji), and outcome (dietary behaviors). Searches were conducted in PubMed, Scopus, PsycINFO, and Google Scholar. The 22 studies included in this review identified different factors influencing dietary behaviors in Fiji. Individual preferences for processed and imported foods, especially of younger generations, and social dynamics, especially gender norms and social pressure, to serve meat and overeat appeared to be prominent in driving dietary habits. The ongoing nutrition transition has led to increasing availability and affordability of ultra-processed and fast foods, especially in urban areas. Concerns about food safety and contamination and climate change and its effect on local food production also appear to influence dietary choices. This review identified different dynamics influencing dietary behaviors, but also research gaps especially with regard to the food environment, calling for an integrated approach to address these factors more systemically.

Predictors of Knowledge, Attitude, and Practice (KAP) Towards Family Planning (FP) Among Pregnant Women in Fiji

ObjectiveThis study aimed to determine the predictors of Knowledge, Attitude and Practice (KAP) towards Family Planning (FP) among pregnant Fijian women.MethodsA cross-sectional study was conducted over two months in 2019 with adult pregnant women attending the Antenatal Clinic (ANC) at Ba Mission Hospital (BMH), Fiji. Data was collected using a self-administrated questionnaire. Statistical analysis included correlation tests and regression analysis in determining predictors of KAP.Results240 pregnant women participated in this study with a mean age of 26.02 (± SD = 4.13). The results showed a moderate level of knowledge (mean 14.95, SD ± 3.15), positive attitude (mean 20.56, SD ± 5.68), and good practice (mean 4.97, SD ± 1.73). Linear regression identified that women with more than seven children had a knowledge score of 3.65, lower than null parity (t value = -2.577, p = 0.011). Women aged 20 to 24 had a 6.47 lower attitude score than women aged 18 to 19 (t value = -2.142, p = 0.033). Women in defacto relationships had a 2.12 lower attitude score compared to the married category (t value = -2.128, p = 0.034). Fijian women of Indian descent had a 1.98 lower attitude score than the I Taukei women (t value = -2.639, p = 0.009). Women aged 30–34 had 2.41 lower practice scores than those aged 18–19 (t value = -2.462, p = 0.015).ConclusionThis study found a medium knowledge of FP among pregnant women. These findings support a recommendation for further research to implement effective strategies.

Characteristics and Predictors of Late Antenatal Booking Among Pregnant Women in Fiji.

Antenatal Care (ANC) plays a pivotal role in improving child and maternal health. Even though antenatal coverage in Fiji is more than 95%, the majority of pregnant women fail to initiate ANC within the first trimester. Thus, the research aimed to determine factors that are associated with late antenatal booking among pregnant women who delivered in Ba Mission Hospital (BMH) in Fiji in 2019. Secondary data analysis was done using SPSS version 24 on 340 pregnant women who had delivered in BMH from January 1 to December 31, 2019 and met the eligibility criteria. A data extraction sheet was used to collect information on socio-demographic, obstetric, and medical factors. The prevalence of late booking in BMH in 2019 was 79.7%. The results of the bivariate analysis showed that being from I-taukei ethnicity (AOR: 2.36; p = 0.003), an unmarried woman (AOR: 2.5; p = 0.004), and women with < eight ANC visits (AOR: 3.7; p < 0.001) during the pregnancy were significant predictors of late antenatal booking. Multivariate analysis showed that only < eight ANC visits were a significant determinant of late antenatal booking (COR: 3.6; p < 0.001). The burden of late antenatal booking in Ba is higher than those of some other developing nations. Efforts are needed to create community awareness on the importance of early ANC booking. The significant factor identified should inform policymakers on how to influence pregnant women to come for an early booking for ANC.

Kunti’s cry: Responses in India to the cause of emigrant women, Fiji 1913–16

The publication in August 1913 of a letter attributed to Kunti, an Indian woman in Fiji, raised an outcry in India. First, the Hindi press took it up; then the Marwaris of Calcutta organised a campaign for the relief of emigrant labourers; and finally, the protection of Indian women in Fiji became a part of the nationalist campaign against indentured labour. This article examines the ideological basis of the agitation, arising from traditional male chauvinism merging with the anti-colonial upsurge, treating especially the reaction in the Hindi press, the Marwari intervention and the nationalist campaign.

Factors associated with breast cancer awareness and breast self-examination in Fiji and Kashmir India \u2013 a cross-sectional study

BackgroundIn low-income countries breast cancer awareness (BCA) is essential to reduce the proportion of advanced stage presentations of breast cancer. There is a lack of studies using multivariable techniques to explore factors related to BCA in low-income countries. The objective of this study was to identify to what extent women in Fiji and Kashmir, India have BCA and practice breast self-examination (BSE) as well as factors associated with BCA and BSE.MethodsA survey of women aged ≥18 years was conducted in Fiji and Kashmir, India to assess BCA and rates of BSE. Comparison between Fiji and Kashmir was done using student’s t-test for continuous data and chi-square for binary data. Factors associated with BCA and BSE were analysed using a multivariable logistic regression for Fiji and Kashmir separately.ResultsData were collected from 399 and 1982 women in Kashmir and Fiji, respectively. Of 1968 women in Fiji 57% were deemed to have an acceptable BCA compared to only 7.3% of 395 women in Kashmir. Having some education was associated with having BCA with an odds ratio of 4.7 (1.7–13) in Fiji and 10 (1.7–59) in Kashmir. Of 1976 women in Fiji 40% had tertiary education while 40% of 392 women in Kashmir had no education at all. The marital status was similar in both samples (n = 1973 and 395) with 68–69% being married and 21–26% being single. The lack of female doctors or nurses with whom to discuss issues, was perceived as a problem in both countries.ConclusionsThe key finding is an association between having any level of education and BCA. This correlation was much stronger than for a family history of breast cancer and BCA. Hence, general education to illiterate women may reduce the proportion of women in low-income countries presenting with advanced-stage breast cancer.

Help-seeking behaviors and practices among Fijian women who experience domestic violence: An exploration of the role of religiosity as a coping strategy

Domestic violence continues to be a persistent social problem, tragically affecting large numbers of women and children. Many religious women look to their faith community for guidance in the aftermath of domestic violence. This article focuses on help-seeking behaviors and practices among Fijian women. Help-seeking behaviors and practices of abused women in Fiji have hitherto received little or no attention and this study seeks to address this lacuna in knowledge and understanding. A qualitative method was employed in the form of in-depth one-on-one interviews with 18 abused women to explore the nature of women’s help-seeking in response to domestic violence. Women in abusive relationships utilized a variety of coping strategies to deal with and heal from the abuse. The findings in this study reveal that in their attempt to survive and heal from experiences of abuse, women turn to their faith in their search for solace, support, and strength. For the women in this study, their faith in God is integral to their healing. This article offers an analysis of how religious involvement also provides women with possibilities of enhanced social and cultural capital that can help to reduce social isolation and enhance support networks. Implications for practice are discussed.

Prevalence of syphilis, gonorrhoea and chlamydia in women in Fiji, the Federated States of Micronesia, Papua New Guinea and Samoa, 1995-2017: Spectrum-STI model estimates.

ObjectiveTo estimate prevalence levels of and time trends for active syphilis, gonorrhoea and chlamydia in women aged 15–49 years in four countries in the Pacific (Fiji, the Federated States of Micronesia [FSM], Papua New Guinea [PNG] and Samoa) to inform surveillance and control strategies for sexually transmitted infections (STIs).MethodsThe Spectrum-STI model was fitted to data from prevalence surveys and screenings of adult female populations collected during 1995−2017 and adjusted for diagnostic test performance and to account for undersampled high-risk populations. For chlamydia and gonorrhoea, data were further adjusted for age and differences between urban and rural areas.ResultsPrevalence levels were estimated as a percentage (95% confidence interval). In 2017, active syphilis prevalence was estimated in Fiji at 3.89% (2.82 to 5.06), in FSM at 1.48% (0.93 to 2.16), in PNG at 3.91% (1.67 to 7.24) and in Samoa at 0.16% (0.07 to 0.37). For gonorrhoea, the prevalence in Fiji was 1.63% (0.50 to 3.87); in FSM it was 1.59% (0.49 to 3.58); in PNG it was 11.0% (7.25 to 16.1); and in Samoa it was 1.61% (1.17 to 2.19). The prevalence of chlamydia in Fiji was 24.1% (16.5 to 32.7); in FSM it was 23.9% (18.5 to 30.6); in PNG it was 14.8% (7.39 to 24.7); and in Samoa it was 30.6% (26.8 to 35.0). For each specific disease within each country, the 95% confidence intervals overlapped for 2000 and 2017, although in PNG the 2017 estimates for all three STIs were below the 2000 estimates. These patterns were robust in the sensitivity analyses.DiscussionThis study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO’s Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.

Factors associated with macrosomia, hypoglycaemia and low Apgar score among Fijian women with gestational diabetes mellitus

BackgroundGestational diabetes mellitus (GDM) in Fiji is a serious public health issue. However, there are no recent studies on GDM among pregnant women in Fiji. The aim of this study was to examine prevalence of, and sociodemographic factors associated with adverse neonatal outcomes among Fijian women with GDM.MethodsWe used cross-sectional data of 255 pregnant women with GDM who gave birth to singleton infants at Colonial War Memorial Hospital (CWMH) in Suva city. Women underwent testing for GDM during antenatal clinic visits and were diagnosed using modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Multivariable logistic regression analysis was used to investigate factors associated with neonatal outcomes.ResultsWomen with a previous baby weighing > 4 kg were 6.08 times more likely to experience neonatal macrosomia (Adjusted odds ratio (AOR) = 6.08; 95%CI: 2.46, 15.01). Compared to unmarried women, the odds of macrosomia among married women reduced by 71% (AOR = 0.29; 95%CI: 0.11, 0.77). Compared with delivery before 38 weeks of gestation, the infants of women who delivered between 38 and 41 weeks of gestation were 62 and 86% less likely to experience neonatal hypoglycaemia and Apgar score < 7 at 5 mins, respectively. The offspring of women who were overweight and obese had higher odds of neonatal hypoglycaemia. Late booking in gestation (≥28 weeks) was significantly associated with Apgar score < 7 at 5 min (AOR = 7.87; 95%CI: 1.11, 55.75). Maternal pre-eclampsia/pregnancy induced hypertension was another factor associated with low Apgar score in infants.ConclusionsThe study found high rates of adverse neonatal outcomes among off springs of Fijian women with GDM and showed that interventions targeting pregnant women who are overweight, had a previous baby weighing > 4 kg, had pre-eclampsia, delivered before 38 weeks of gestation, and those who booked later than 13 weeks in gestation, are needed to improve pregnancy outcomes.

Hyperendemic Chlamydia trachomatis sexually transmitted infections among females represent a high burden of asymptomatic disease and health disparity among Pacific Islanders in Fiji

BackgroundChlamydia trachomatis is the most common bacterial sexually transmitted infection worldwide with some of the highest prevalence rates among Pacific Island Countries where syndromic management is practiced. However, little is known about the true prevalence and risk indicators for infection among neglected populations in these countries that suffer from health disparities.Methodology/Principal findingsConsecutive sampling was used to enroll sexually active females, aged 18–40 years, attending 12 Fijian Ministry of Health and Medical Services Health Centers and outreach locations from February to December, 2018. A Behavioral Surveillance Survey was administered to assess risk indicators for infection. Signs and symptoms were recorded, and vaginal swabs were tested for C. trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Candida and bacterial vaginosis. Bivariate and multivariate logistic regression analyses were performed using R-Studio. Of 577 participants, 103 (17.85%) were infected with C. trachomatis of whom 80% were asymptomatic and only 11 met criteria for syndromic management; 38.8% of infected women were 18–24 years old with a prevalence of 30.5%. 91.7% of participants intermittently or did not use condoms. C. trachomatis infection was associated with iTaukei ethnicity (OR 21.41 [95% CI: 6.38–133.53]); two lifetime partners (OR 2.12 [95% CI: 1.08–4.18]); and N. gonorrhoeae co-infection (OR 9.56 [95% CI: 3.67–28.15]) in multivariate analyses.ConclusionsA disproportionately high burden of C. trachomatis is present among young asymptomatic women in Fiji of iTaukei ethnicity despite the low number of lifetime partners. Syndromic management and lack of barrier contraceptives contribute to hyperendemic levels. Strategic STI education and screening of at-risk adolescents, young women, and their partner(s) with appropriate treatment are urgently needed to control the epidemic.

Social Norms and Smoking Risk in iTaukei Fijian Adolescent Women.

To investigate the association of a variety of social smoking exposures with cigarette smoking among iTaukei adolescent women in Fiji. Self-report data were collected in a representative sample of school-going iTaukei adolescent women (n=523). We fitted logistic regression models of current cigarette smoking with school, peer, media, and other social exposures to smoking as predictors. Current cigarette smoking was associated with exposure to close friend, peer, and routine social smoking as well as higher prevalence of school peer smoking, but not parent tobacco use and media smoking exposures-in our fully adjusted model. Peer and school-based smoking exposures may increase cigarette smoking risk in school-going iTaukei adolescent women and may be strategic interventional targets to augment existing preventive approaches.

The 1924 Empire Cruise and the Imagining of an Imperial Community

This article examines the cultural contours of the Royal Navy's postwar ‘Empire Cruise’. In late 1923, the British government dispatched a ‘Special Service Squadron’ of powerful battlecruisers on a massive public relations tour. But the popular response to this carefully orchestrated propaganda stunt varied widely. Settler populations in the Dominions often embraced the navy as a ‘bond of empire’ that reconciled Britishness with their own emerging national identities. They celebrated the navy as evidence of a shared maritime heritage handed down over the course of centuries. Meanwhile, non-white populations often responded in ways that ran counter to the intentions of the event organizers. Zulu villages in Natal hosted athletic competitions and indigenous women in Fiji organized a dance for the visiting Jack Tars – unsanctioned gatherings that offered alternative points of contact to the existing arrangements. In other locations, anti-colonial nationalists took advantage of the publicity surrounding the navy to mobilise against colonial policies. Ultimately the appearance of the navy in the far-flung ports of the empire stimulated widespread public debates about race, identity, and colonialism, and challenged the intended narrative of imperial unity.

Fertility preference of pregnant women attending the Colonial War Memorial Hospital (CWMH) Antenatal Clinic, Suva, Fiji Islands, 2015

Background: There are more than two hundred million women in developing countries of childbearing age who do not use modern contraceptives but wish to avoid pregnancy. The Total Fertility Rate (TFR) in Fiji remains moderately high at 2.6 children per woman. This survey was conducted to identify the fertility preferences of pregnant women attending the Colonial War Memorial Hospital (CWMH) Antenatal Clinic, in Suva, Fiji Islands.&#x0D; Methods: This descriptive cross-sectional study was conducted among 2,203 pregnant women who attended the antenatal clinic of CWMH in Suva between May 2014 and December 2015. A self-administered questionnaire was used to collect the data. Using purposive sampling, those who met the study inclusion criteria were asked to answer the questionnaire. The collected data was analysed using SPSS and descriptive statistical analysis and the results are shown in tables and graph format.&#x0D; Results: The majority of participants were aged 20 to 24 years old (36.3%) and more than two thirds of them were married (88.1%). Ninety-one percent of the participant’s partners were employed and 58.3% of them were living together for 0 to 4 years. Fifty one percent were 20 to 24 years at the time of first sexual intercourse. The best spacing time to wait between pregnancies was reported to be 3 years (37.4%), followed by 2 years (27.3%) and 4 years (12.8%). One third of participants (34.5%) preferred to have one child after this pregnancy. A majority of participants were planning to have 3 to 4 children (48.6%) when they were nulliparas. Importantly 50.3% of women did not want any more children after this pregnancy highlighting an unmet contraception need.&#x0D; Conclusion: The results of the study highlighted the fertility preference of pregnant women in Fiji and the factors affecting it. This study will give insights to decision makers to develop interventions based on the influencing factors which can affect promoting family planning among Fijian women.

Awareness and use of family planning methods among iTaukei women in Fiji and New Zealand

ObjectiveiTaukei women's awareness and practice of family planning methods was investigated in New Zealand and Fiji to ascertain differences in behaviour within the context of changing developmental settings. MethodsThe study was cross‐sectional in nature and recruited women aged 18 years and over from three suburbs in Suva, Fiji, and five cities in New Zealand. ResultsOverall, 352 women participated in the study, 212 in Fiji and 140 in New Zealand. The study found that living in New Zealand was significantly associated with lower odds of being aware of family planning (OR 0.4, 95%CI 0.2–0.9, p=0.029) and using family planning methods (OR 0.5, 95%CI 0.2–0.9, p=0.027). Tertiary education was found to increase the odds of being aware (OR 2.8, 95%CI 1.3–6.2, p=0.009) and of using (OR 3.9, 95%CI 1.9–7.8, p=0.000) family planning. ConclusionsDespite the greater availability of services and higher standards of living experienced in New Zealand compared with Fiji, there was no improvement in awareness and use of family planning among New Zealand participants. Implications for public healthReduced awareness and use of family planning in New Zealand indicates a need for better targeting of services among minority Pacific ethnic groups.

Knowledge, Attitude, Practice and Barriers Regarding Safe Sex and Contraceptive Use in Rural Women in Fiji

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Fiji has a low contraceptive uptake rate and high rates of unplanned pregnancy and sexually transmitted infections (STIs). In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to safe sex and contraceptive use, conducted on 1494 rural women aged between 18 to 75 years in Fiji.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives:&lt;/strong&gt; To explore the knowledge, attitudes, practice and barriers regarding safe sex and contraceptive use in rural women of Ba, Lautoka and Nadi, in Fiji.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Structured questionnaires were administered to women presenting to rural outreach Sexual and Reproductive Health (SRH) education sessions and clinics conducted by trained health educators and clinicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Knowledge on how pregnancy occurred and how to avoid pregnancies was high&lt;strong&gt; &lt;/strong&gt;(86% and 83% respectively); but when it came to practice 43% of women had never used a contraceptive. Despite 81% of women having completed either secondary or tertiary education, 88% were not aware of emergency contraception. Fifty three percent of respondents were unaware that condom use provided protection against both pregnancy and STIs. Sixty three percent knew how an STI is contracted but 48% were unaware of any of the symptoms of STIs. Women offered ‘lack of knowledge’ (53%), ‘being married’ (17%), ‘difficulty accessing’ (10%) or ‘partner disagrees’ (7%) as the common barriers to condom use. Forty percent of women were unable to articulate a barrier to contraceptive use and said they did not know whereas 21% said ‘fear’, 15% said ‘partner objecting’ and 5% said ‘religion’ were barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While a high percentage of women had some knowledge of how to avoid pregnancies and how STIs were contracted, this did not translate to practice of safe sex or use of contraceptives.&lt;strong&gt; &lt;/strong&gt;Review of current education and health programs is necessary to ensure that misinformation and false perceptions do not act as barriers. The influence of the partner needs further research.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Knowledge, Attitude, Practice and Barriers regarding cervical cancer and its screening using Pap smear, in rural women of Ba, Lautoka and Nadi, Fiji.

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: Fiji has a high rate of cervical cancer, which is the second most common cause of cancer deaths in women in the country. Less than 10% of women are screened for cervical cancer in Fiji.In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to cervical cancer and its screening with Pap smears, conducted on 1505 rural women in Fiji.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives:&lt;/strong&gt; To assess the knowledge, attitudes, practice and barriers to cervical cancer and it’s screening with Pap smears in rural women of Ba, Lautoka and Nadi, in Fiji.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: Structured questionnaires were administered to women presenting to a rural outreach Reproductive Health education and clinics, by trained health educators to ascertain their Knowledge, Attitudes, Practice and Barriers to cervical cancer and its screening with Pap smears.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;: Seventy two percent of rural women had no knowledge of cervical cancer and 80% had no knowledge of the risk factors of cervical cancer. Lack of knowledge was significantly different for age groups (p=0.006), education levels and employment status(p&amp;lt;0.001) and ethnicity (p=0.022). Those groups with lowest knowledge were teenagers (18 to 19 years); those with less education; and iTaukei respondents. Of the respondents who had at least some knowledge of the Pap smear, 75% had had a Pap test. Of those who had no knowledge of the Pap smear, only 45% had had the test (p&amp;lt;0.001). Of those who did not have a Pap smear the commonest barrier was lack of knowledge at 46.3% and fear of procedure was 29.4%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: More education is required to acquaint women in rural Fiji about cervical cancer, its associated risk factors as well as the benefits of cervical cancer screening programs and other prevention strategies. &lt;/p&gt;

Women in the House (of Parliament) in Fiji: What’s Gender Got to Do with It?

Women in Fiji have made steady, albeit slow, progress in terms of parliamentary representation, with women now holding 14% of seats in the lower house of parliament. Some of the progress has occurred as a result of improvements associated with increased socio-economic development, such as education, female employment and incremental changes in women’s standing in Fiji society. Much of this change, however, has been due to women’s movements and civil society activism becoming more astute to concerns of gender equality and lobbying for women’s political participation. In a country that witnessed four political coups, women have had to create their own path into the public sphere. Despite progress, with an increasing number of women in the 2014 parliament, patriarchy is still a major force hindering women’s political advancement in Fiji. This paper argues that a combination of cultural stereotyping and persistent gendered norms contribute to masculinisation of the political realm and eulogise women’s role in the private sphere. But gender intersecting with ethnicity, age and class create differential levels of political agency for different groups of women in Fiji.

Prevalence of HPV infection and other risk factors in a Fijian population.

BackgroundCancer is among the leading contributors to morbidity and mortality in the Pacific, but the magnitude of the problem and the potential for prevention have not been comprehensively studied. Over the past decade, cervical cancer has been the most common cancer among women in Fiji with an age standardised cervical cancer incidence rate of 51 per 100,000. This rate is among the highest in the South Pacific region and in the world. This high cervical cancer incidence rate is likely linked to the low cervical screening rate, but it points also to the possibility of a high burden of human papillomavirus (HPV) infection.MethodsWe conducted a population-based survey in Fiji to provide information on human papillomavirus (HPV) prevalence, and the distribution of individual HPV types in a Fijian health-sub-district. We included 1,261 women aged between 16 and 64 years. A general primer GP5+/6+ mediatedpolymerase chain reaction (PCR) assay was used for HPV testing of 44 HPV types.ResultsThe crude HPV prevalence in 1,244 women with an adequate HPV sample was 24.0% (95% confidence interval (CI), 21.7-26.4%) and the corresponding age standardised prevalence was 25.5% (95% CI, 23.1-28.1%). The prevalence of high-risk HPV types was 13.6% (95% CI, 11.8-15.6%). Among 1,192 women with adequate cytological results, 13 (1.1%) showed cervical abnormalities, the majority of which were high-grade intraepithelial lesions or worse. HPV prevalence declined from 35.8% in women aged <25 years to 18.6% in those aged 55–64 years of age. After adjustment, the only variables significantly associated with HPV-positivity were age (ranging from odds ratio (OR) 0.57 (95% CI, 0.36-0.89) for 25–34 year-old-women to OR 0.43 (95% CI, 0.20-0.89) for 55–64 year-old-women) and ‘husband’s extramarital sexual relationships’ (OR 1.69; 95% CI, 1.17-2.34).ConclusionThese findings on HPV provide key information for future policy decisions on the most appropriate methods of cervical cancer prevention in Fiji and in the Pacific region.