Addressing reproductive health knowledge, infertility and coping strategies among rural women in India.

An awareness of fertility and the factors affecting it is crucial to dealing with infertility, though little research has been conducted in the context of rural India. This study assessed Indian women's perceived causes of, and strategies for coping with, infertility and the associations with levels of reproductive health knowledge in rural areas. Primary data were collected through mapping and listing in high infertility prevalence districts of West Bengal in 2014-15. A total of 159 women aged 20-49 years who had ever experienced infertility were interviewed. A Reproductive Health Knowledge Index (RHKI) was computed to indicate respondent's level of reproductive health knowledge, and to show its association with perceived causes of infertility and coping with infertility. The highest mean RHKI score was observed among women in the lowest age group (RHKI=5.75, p<0.001), those with a higher level of education (RHKI=9.39, p<0.001) and those who had exposure to any media (RHKI=5.88, p<0.001). Women with a poor wealth index (RHKI=2.11, p<0.01) and those from Scheduled Caste, Scheduled Tribe and Other Backward Class communities (RHKI=4.20, p<0.05) had lower RHKI scores than richer women and those from General Caste communities. Women with a higher RHKI score were more likely to give biology (98.0%, p<0.001), old age (94.1%, p<0.01) and repeated abortions/accident/injury (92.2%, p<0.001) as reasons for infertility, whereas women with a low RHKI were more likely to give religious (73.2%, p<0.001) and old-age-related causes (75.0%, p<0.01) of infertility. Women with a high RHKI score were more likely to opt for modern allopathic treatments (RHKI=7.04, p<0.001), whereas those with a low RHKI score were more likely to seek treatment from religious and superstitious practitioners, use home remedies or receive no treatment at all (RHKI=1.66, p<0.001). Appropriate reproductive health knowledge is crucial if rural Indian women are to correctly assess their infertility problems and choose effective coping strategies.