Assessment of knowledge, attitude, and practices of women regarding vaginitis in Mosul, Iraq: a mixed-methods study

Vaginitis is one of the most common gynecologic presentations worldwide and is a leading cause of reproductive morbidity that significantly impacts on quality of life. The objective of this study was to assess gaps in women’s knowledge, attitudes, and practices (KAP) towards vaginitis in Mosul, Iraq. A hospital-based study was carried out over three years, starting from April 2022 to May 2025 in Mosul city, north of Iraq. The research consisted of mixed quantitative cross-sectional conducted on 500 women and qualitative approach using semi-structured interviews using purposive sampling. A structured coding system was applied to assess KAP among participants using SPSS statistical analysis. Bivariate analysis using chi square followed by multivariate logestic regression was used to analyze the possible association between variables and score. The commonest age affected among participants was 26–35 years, and the majority were housewives, married, and with limited those who had higher education. Good knowledge was present in 38.8% and good practice in 39.4%. A favorable attitude was presented in 33.4%. Recurrence of vaginitis was present in the majority of the participants who had repeated episodes of 2–3 times or more per year. The Qualitative narratives consolidate the findings of little awareness and presence of cultural stigma, home remedies, with little partner involvement in health care. Multivariate logestic regression shows that Education was significantly associated with knowledge level, with lower-educated women having markedly reduced odds of good (vs. poor) knowledge compared to university-educated women (AOR = 0.060, 95% CI: 0.028–0.130, p < .001). Attitude level was significantly associated with residence, education, and socioeconomic status, with rural residence showing the strongest association: rural women had markedly reduced odds of moderate (vs. good) attitude compared to suburban women (AOR = 0.046, 95% CI: 0.020–0.104, p < .001). Knowledge, attitude, and practice levels were significantly associated with one another (all p < 0.001). Women with good knowledge were more likely to have favorable attitudes and good practices, while unfavorable attitudes were predominantly associated with poor practices. Practice level was significantly associated with residence, education, and socioeconomic status, with rural residence showing the strongest association: rural women had significantly higher odds of poor (vs. good) practice compared to suburban women (AOR = 3.080, 95% CI: 1.679–5.652, p < .001). The study revealed large gaps in women's knowledge, attitudes, and practices regarding vaginitis, and this gap was statistically significantly associated with lower educational background and poor residence environment. Improving knowledge significantly improves their practice and decreases suffering. Frequent recurrent episodes are indications of unsuccessful primary prevention and healthcare-seeking behaviors. These data underscore the need for targeted education about symptoms of vaginitis; methods of transmission; when to seek care; preventive practices; and involving partners in order to decrease recurrence rates and improve health.