Breaking the Silence: Assessment of Cultural Barriers in Discussing Sexual Health with Married Women in Pakistan 

Sexual health is a core element of a women’s overall well-being, today in Pakistan, married women facing a significant cultural barriers in discussing sexual health concerns. Undefined taboos surrounding sexuality, concept of ‘Haya’ and religious misinterpretations create an environment where such topics are considered inappropriate and shameful. These barriers results, more women remain silent about sexual health issues such as pain during intercourse, menstrual problems, and infections. This blog aims to explore the cultural challenges that prevent meaningful communication around sexual health, assess their impact on married women, and highlights the importance of breaking this silence in inclusion of public health goals, definitely sustainable development goal 3 (SDG 3): The Theme of the SDG is Good Health and Well-being. 

Married women have not sufficient knowledge regarding sexual and reproductive health due cultural dilemmas, undefined religious factors and poor educational background. Cultural barriers is the key factor influence the sexual health of married women due to gender dynamics in some countries from inhibiting them from making their own decision about sexual health in terms of contraception, interval between childbirth, and number of children. This assertiveness intensely impacts women’s sexual and reproductive health and also influences their positive attitude towards healthcare seeking curiosity. Fear of breaching confidentiality and stigmatization from healthcare workers are also barriers to break the silence and to discuss their potential sexual health concerns (Alomair et al., 2020). 

The sexual health deprivation is a serious concern around the globe, which directly affect maternal and child health. As study shows Kenyan and Somalian women are suffering from the genital mutilation’s complications and they are limited to seek the healthcare due to socio-cultural and structural taboos. These female are bound to their cultural norms which should be followed with non-addressing behavior and complications (Kimani et al., 2020). In Pakistan, Bangladesh, and Malaysia modesty and shyness is one of the key barrier to female sexual health education.

They are obligated to follow the rules with no rationales, and are abide to reveal sexual health concerns to the women to whom they are closer. There is no guarantee that women gets communicated by affected women has sufficient knowledge regarding sexual health Mustafa et al. (2021). These countries are more prone to work on SDG 3 a good health and well-being. 

Furthermore, sexual health considers, is a sensitive topic and the pretentious seek traditional and spiritual healers to overcome with concerns. There is a huge gap of study to get rid of these taboos which is one of the most important barriers to be dispersed (Omer et al., 2021). Study specifies to district Thatta Sindh in which gender-based discrimination highlighted, men are dominate over women in every aspect of their lives, female depends of male and doesn’t look for healthcare rather they are not getting permission from men and mostly the men are go with in favor of religious healer rather medical health (Asim et al., 2021).  

In terms of hygienic conditions, a study explored the menstrual health and perineal care during the monthly cycle of women, whereas cultural stigma defined the menstrual cycle as “secrecy” and discourages female from disclosing this impurity. Women are restricted to not to seek help from healthcare providers during menstrual cycles and problems related to the periods.

We can find a huge gap between healthcare providers and women to discuss about the menstrual cycle and unhygienic practices related to monthly cycle, because of the lack of education and taboos implemented by the culture. Most of the women wearing cut piece of clothes as undergarment despite of pads during periods (Arshad Ali et al., 2020). 

These cultural barriers directly hinder the progress of Sustainable Development Goal 3 which emphasizes universal access to sexual and reproductive healthcare. Breaking the silence around sexual health is not just a matter of communication; it’s a matter of health, dignity and rights of women. Barriers that prevent married women in Pakistan from discussing sexual health contribute to a monthly cycle misinformation and preventable health risks.

To overcome these cultural barriers healthcare providers and communities need to work with collaboration and create culturally sensitive spaces where women can freely access accurate information and care without any hesitation and shame. Aligning these efforts with SDG, ensures that sexual and reproductive health becomes a vital part of promoting well-being for all.6 

References 

Alomair, N., Alageel, S., Davies, N., & Bailey, J. V. (2020). Factors influencing sexual and reproductive health of Muslim women: a systematic review. Reproductive Health, 17(1), 33. https://doi.org/10.1186/s12978-020-0888-1  

Arshad Ali, S., Baloch, M., Riaz, L., Iqbal, A., Riaz, R., Perveen, B., Siddiqui, M., & Arshad Ali, A. (2020). Perceptions, Practices, and Challenges Regarding Menstrual Hygiene Among Women in Karachi, Pakistan: A Comparison Between General Population and Healthcare Workers. Cureus, 12(8), e9894. https://doi.org/10.7759/cureus.9894  

Asim, M., Saleem, S., Ahmed, Z. H., Naeem, I., Abrejo, F., Fatmi, Z., & Siddiqi, S. (2021). We Won’t Go There: Barriers to Accessing Maternal and Newborn Care in District Thatta, Pakistan. Healthcare (Basel), 9(10). https://doi.org/10.3390/healthcare9101314  

Kimani, S., Kabiru, C. W., Muteshi, J., & Guyo, J. (2020). Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study. BMC Int Health Hum Rights, 20(1), 3. https://doi.org/10.1186/s12914-020-0222-6  

Mustafa, M., Zaman, K. T., Ahmad, T., Batool, A., Ghazali, M., & Ahmed, N. (2021). Religion and Women’s Intimate Health: Towards an Inclusive Approach to Healthcare Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems, Yokohama, Japan. https://doi.org/10.1145/3411764.3445605 

Omer, S., Zakar, R., Zakar, M. Z., & Fischer, F. (2021). The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan. Reprod Health, 18(1), 97. https://doi.org/10.1186/s12978-021-01151-6  

Nisar Ahmad

Former clinical instructor at Bilal Institute of Nursing and Health Sciences Lower Dir KP. Pakistan

Currently enrolled in MScN, accomplished Post RN BSN, Diploma in Cardiac Nursing, Diploma in General Nursing

Research interest: Public Health, Assessment of Cultural Barriers in Discussing Sexual Health with Married Woman in Pakistan.

Professional experience: Up to 5 years of experience in cardiac and medical-surgical unit in clinical as well as clinical instructor