Factors associated with the awareness of vaginal fistula among women of reproductive age: findings from the 2018 Nigerian demographic health cross-sectional survey

Abstract

IntroductionInvoluntary leakage of urine and or stool per vaginam (vaginal fistula) after childbirth remains a public health challenge in Africa and South East Asia. To the best of our knowledge, there is no previous national data that examined the awareness of vaginal fistula among women in Nigeria.AimTo determine the prevalence of awareness of urinary/faecal incontinence due to vaginal fistula, and the associated risk factors among women with no previous experience of incontinence.MethodsWe used a cross-sectional study, the 2018 Nigerian Demographic Health Survey, to analyse awareness of vaginal fistula among women with no previous leakage of urine or stool. The primary outcome was childbirth experience, and other variables were demographics, access to information and reproductive or sexual history. The descriptive, univariate and multivariable models were presented.ResultsOf 26 585 women interviewed, 50 (0.2%) who had experienced fistula were excluded from the risk factor analysis. The mean age of women with childbirth experience was 32.8±8.6 years, while that of women without childbirth experience was 20.3±6.2 years. The prevalence of vaginal fistula awareness was 52.0%. Factors associated with the awareness include the following: childbirth experience (adjusted OR (AOR)=1.14; 95% CI, 1.01 to 1.30); age of 20–24 years (AOR=1.36; 95% CI, 1.18 to 1.56) and older; currently working (AOR=1.35; 95% CI, 1.22 to 1.49) and ownership of a mobile phone (AOR=1.16; 95% CI, 1.05 to 1.27). Other associated factors include the following: having at least secondary education; wealth quintiles, ethnicity, regional location, religion, access to radio, newspaper and internet; age up to 17 years at first sex; history of previous termination of pregnancy and use of contraception.ConclusionA significant number of young women with no childbirth experience had low level of awareness. We recommend vaginal fistula awareness programmes that will target women at risk of vaginal fistula and the inclusion of other useful questions to improve the quality of information in future surveys.

Awareness of obstetric fistula and its associated factors among women of reproductive age in sub-Saharan Africa

“…Compared to women who were exposed to mass media, women who were not exposed to mass media were less likely to be aware of OBF. The result corroborates the findings of previous studies as evidenced in Nigeria [ 15 ] and Ethiopia [ 7 ]. Presumably, the findings could be due to the fact that mass media is a key conduit for disseminating information including information about OBF, its signs and symptoms as well as information about where to access treatment.…”

Women’s Awareness of Obstetric Fistula and its Associated Factors Among Reproductive-Age Women in Ethiopia: A Multilevel Analysis Based on National Survey Data

“…Attending formal education has had higher odds than not attending formal education for fistula awareness. The finding agrees with studies done in the Awi zone of North West Ethiopia, Bench sheka zone, south, Ethiopia Burkina Faso, and Northern Ghana [7, 9, 11]. The possible explanation for these might be those attending formal education have greater opportunities to get information, asking, and getting health services than those who hadn’t attended formal education.…”

“…Older women had high odds of fistula awareness compared to young age women; this is might be due to that older women have had different or multiple exposures to media, different health education forums and they have had better opportunities to access/engage in health care services including counseling services [11]. Attending formal education has had higher odds than not attending formal education for fistula awareness.…”

“…Pieces of evidence show that the risk of the vaginal fistula is common in settings with a lack of inadequate emergency obstetric care, healthcare workforce shortages, and poor investment in maternity services [6, 10]. Further, sociocultural issues such as early marriage, harmful cultural practices like female genital mutilation, home-based childbirth, poor policy implementation of female education, and misconceptions about childbirth practices are other contributing factors for the high burden of obstetric fistula in Sub-Saharan Africa [11, 12]. Adequate information and awareness of the risk factors, causes, and treatment options for vaginal fistula may help women to take appropriate steps to prevent vaginal fistula.…”

Awareness of obstetric fistula and its associated factors among reproductive-age women in Ethiopia: a multilevel analysis of Ethiopian Demographic and Health Survey data: a cross-sectional study

“…When compared with younger women, older women had a higher likelihood of being aware of obstetric fistula; this could be because older women have had more or different exposures to media, different health education forums, and better opportunities to access/engage in healthcare services, including counselling services. 11 Attending formal education has had higher odds than not attending formal education for fistula awareness. The finding is consistent with studies done in the Awi zone of North West Ethiopia, Bench Sheka Zone, south, Ethiopia Burkina Faso and Northern Ghana.…”