| Background In recent years, people are deeply known of the importance of women’s physical and mental health improvement, which significantly influences entire human health condition. With the increasing number of women graduate students in Tibet region, people have researched on Gynecology of Tibetan medicine to make more or less contribution for improving Tibetan women’s health. But the further research is needed, such as the analysis of an area’s common gynecological diseases prevalence, primary and secondary risk factors, high-risk population, the interaction between risk factors, the association between risk factors and common gynecology diseases, the vertical and horizontal prognosis of common gynecology diseases, and its relevant prevention strategies and so on.Objectives This study used life course conceptual framework, firstly to analyze diet and physical behavior wellbeing methods, secondly to sum up the prevalence of common gynecological diseases, thirdly to discuss tertiary prevention measures, across the life course by Tibetan Medicine theories combines with Public Health. First, based on the relevant literature of Tibetan medicine, to clarifying the age classification gist and physiological features across the life course; to analyze diet and physical behavior health measures for women’s special physiological period; to probe into five basic gynecological ailment varieties further categories, and vertical and horizontal prognosis of common gynecology diseases. Second, through public health literature research, to summarize high prevalence of gynecological diseases and leading cause of death across the life course; to absorb experiences of domestic and international modeling maternal and child health project’s effective program implementation strategies, for discussing preliminary prevention work by Tibetan Medicine theories combines with Public Health. Third, by field investigation and research in nomad county in Zeku, to explore high prevalence of gynecological diseases across the life course; to select high-risk population and townships; to present tertiary risk factors; to discuss primary and secondary factors; to describe the relationship between risk factors and gynecological diseases; to summarize the experiences from currently undertaken maternal and child health projects,and finally to base on literature research, discussing further more project to be needed implementation, for providing reference to the community prevention works.Methods The method of combing theoretical research and filed analysis is adopted for the research, and methods such as literature research, field investigation, questionnaire survey, interview and other relevant data statistical analysis are used to conduct research. The method of literature research is adopted to fully review the existing Tibetan medicine classic books and modern journal articles, public health books and articles, video, policy documents, by using comparative, analysis, induction and summary of the literature research methodologies.The method of investigation is adopt to investigate maternal and child health project center, to consult the relevant staffs for providing guidance to the combination of theory and practice. The method of questionnaire survey is adopted to carry out filed survey, selecting 204 reproductive age women, whom are participated Tsoghon university health fair in Zeku County, by a self-designed questionnaire including demographic information, present general health condition and risk factors of women’s special physiological periods. The method of interview is adopted to visit ten experienced, local county and township level maternal and child health workers, for learning about further explain the result of quantitative data analysis obtained by the questionnaires survey. The method of investigation is adopt to collect other relevant data such as analyzing 1128 patient’s gynecological and general health raw data, whom are participated Tsoghon university health fair in Zeku County, and also analyzing 1723 women’s cervical cancer screening original data, whom are participated in free public health programs in Zeku County. In the statistical analysis, the qualitative recorded data was transcript in text, and analyzing with other type of data together; the quantitative data was analyzed by Stata version 14, performing Fisher’s test, Chi square test, Analysis of variance and Logistic regression.Results Main research results are yielded by Tibetan medicine literatures include: 1. In classification of the life course periods, there are fifteen weeks and five months which affects more for women’s reproductive health during pregnancy, and nineteen key periods after the birth. 2. In physiological features across the life course, I have discussed reproductive organs development of each month in gestation period, the interaction between three Nyba and physiological changes across life course, especially during menstrual period, and reproductive organs decline period. 3. In terms of emotion changing of across the life course, I have analyzed the conscious changing process during gestation period, and how three period, three Nyba, seven constitution type affected emotion changing of across the life course, and especially how external factors influenced emotion changing during women’s six special periods. 4. About women’s special period dietary wellbeing care, I have based on Tibetan medicine dietetic theory and Chinese medicine theory of hot and cold dietetic function, to explore six special periods dietary wellbeing care. 5. About women’s special period behavior wellbeing care, I have made explanation of five special period’s behavior choice, especially interpretation of the ten indispensable behavior choice during gestation period. And mechanism of sixteen behavior choices during intra-partum. 6. About the classification of gynecological diseases, I have summarized nine characteristics of gynecological diseases, expanding five major categories of gynecological diseases, according to the causes, metastasis sites, location, three Nyba and complications etc. 7. For the vertical and horizontal prognosis of common gynecology diseases, firstly, I have analyzed mechanism of the six common gynecological diseases separately. Secondly, the six ways of prognosis of gynecological diseases across the life course. Main research results are yielded according to public health literatures include: 1. Summarizing major factors of six high prevalence of gynecological diseases across the life course. 2. Summing up thirty-five leading cause of death across the life course by six age classification. 3. Concluding main factors of the twelve psychological problems across the life course.4. Reviewing main achievements and experiences of the sixty programs, for improving women’s health condition across the life course. 5. Absorbing three levels of behavior change theories and eight effective program implementation strategies. 6. Discussing five preliminary prevention works, by Tibetan Medicine theories combines with Public Health. Main research results by field investigation in Nomad Zeku County include: 1. The distribution of high prevalence of gynecological diseases across the life course shows, though under fifteen years old, the prevalence of gynecological diseases is very low, but the vulva pruritus and genital abscess are relatively high prevalence than others. At the age of above seventeen years of old, the highest prevalence of three gynecological diseases are cervical erosion, cervical hypertrophy and vaginal worm disease.(p>0.05) the prevalence of uterine fibroids is higher in above thirty-five years age group than other age groups.(p< 0.05) Among 44 to 59 years old,there is a high prevalence of in patients’ suspected cervical cancer,(p< 0.05) particularly among them in cervical lesion prevalence was 83%, and 48% of them with severe cervicitis, 7% of them suspected of having a cervical cancer.2. Selecting high-risk population and townships outcome shows, that the prevalence of vaginal worm disease, abortion and fetal death frequency of township B was higher than other townships.(p<0.05) the prevalence of uterine fibroids of township A was significantly higher than other townships.(p>0.05) and cervical disease morbidity of township A, G, F, B increased orderly. Therefore, A and B are the two main townships, which are in urgent need of prevention of gynecological diseases.3. The distribution of general disease shows that arthritis and gastritis are highest prevalence of the diseases, especially under the age of fifteen gastritis is the high prevalence disease, and over the age of fifteen arthritis is the high prevalence disease.(p< 0.05).4. Exploring three level risk factors outcome shows, among 76 risk factors there are ten major risk factors related to personal and family level, and other thirteen major risk factors associated with the community level. Especially the women’s education level increasing each additional year, the utilization of pregnancy, parturition and postpartum health care increased 3.62 units.(p< 0.05).5. Discussing seven strategies of further implementation of the project for improving Tibetan women’s health in Zeku County, based on reviewing literature research and summarizing the experience from eight currently undertaken maternal and child health projects.Conclusion Study results by literature review shows that Women’s physiological changes across the life course is significantly, so based on physiological change process and “Dakgor” to provide wellbeing care and treatment is the priority; Using life course conceptual framework for Women’s health improvement, by implementing feasible intervention by the guidance of reliable data; Tibetan medicine contains varities wellbeing care methods, which proved by mordren research, so it’s crutial to inherit and to develop wellbeing care methods in Tibetan medicine. Study results by field investigation in Nomad Zeku County shows that Tibetan women are very poor in health condition, but the type of gynecological diseases and primary and secondary risk factors across the life course were clarity, so there is opportunity to goal-oriented improvement of Tibetan women’s health condition; For improving women’s health, different organization needs to provide a variety of direct and indirect interventions. |
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