An Exploratory Study of Reintegration of Women Following Obstetric Fistula Surgery in West Pokot, Kenya

Abstract

Globally, obstetric fistula has been eradicated in developed countries although it continues to pose challenges to women living in sub-Saharan Africa and Asia. The condition continues to contribute to maternal morbidity in Kenya, causing immense physical and psychological suffering and disrupts women's socioeconomic life. Following corrective surgery, experiences of Pokot women in their quest for social reintegration, a broadly neglected aspect of their healing process, are documented in an exploratory study. Primary data were collected over a 2-month period in rural Kenya using in-depth interviews with women who had undergone surgery and key informants. Thematic data analysis based on grounded theory revealed avenues for reintegration including successful surgery, family and community support, counseling, follow-up care, income generating activities, and skill training.

Social reintegration service after fistula repair and its challenges in North Gondar, Ethiopia: Women’s perspectives: A qualitative study

“…The success of surgery was the key component of reintegration that hastens complete recovery and found to be the priority need of patients with stula. Similar to our study ndings, different studies in Africa found that most repaired women regained continence, and successful stula closure was the most important step in their reintegration (3,(7)(8)(9). Although some complained about urine spills with strenuous activity or coughing, many had improved continence and physical health that gave hope for returning to their pre-stula life.…”

“…They also felt that support was from organizations other than the government, and therefore requested 'government attention' and holistic support, including space to recuperate in their community and free health service until they fully recovered. A study in Kenya also revealed the need for government attention for holistic management of stula (9).…”

“…Thus, respondents would love to receive health professional advice and support at easy access as part of the reintegration service. Studies conducted in Eritrea and Kenya also magni ed the need for a formal counseling service and its positive impact on improving women's knowledge of stula, in order to improve self esteem (9,14).…”

“…This study found that strengthening interpersonal relationships was the most important part of reintegration next to physical repair. Therefore, rehabilitation and connecting women to their community is vital (3,9,15). Follow-up services could create an opportunity for counseling, identifying individual woman`s needs, and link them to income-generating activities…”