Healthcare providers’ perspectives on the social reintegration of patients after surgical fistula repair in the eastern Democratic Republic of Congo

Young‐Lin, Nichole; Namugunga, E.N.; Lussy, Justin Paluku; Benfield, Nerys

doi:10.1016/j.ijgo.2015.03.023

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…One important area of support women required after OF surgical repair was with their husbands to abstain from sex [15]. The mere feeling of being accepted back in society where people depend on each other was emotionally and psychologically therapeutic for many women [20,27]. Women recovering from OF also valued home visits as these were a source of encouragement [14].…”

Section: External Supportmentioning

confidence: 99%

Social support for women after fistula repair: A scoping review

Wella

Chilemba

Namathanga

et al. 2021

Sexual & Reproductive Healthcare

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Background Obstetric fistula (OF) is a birth complication that largely affects women in developing countries. The women suffer constant incontinence, shame, social segregation, and health problems.Reconstructive surgery can usually repair OF, and enable women to reintegrate back into their communities. However, physically repair does not necessarily result in emotional recovery. Our objective was to explore women's experiences of social support during the twelve months following a first time OF repair. Methods An evidence synthesis was performed based on a systematic search of literature published between 2008 and October 2019 in PubMed, Medline and CINAHL databases using keywords "Obstetric Fistula", "vesicovaginal fistula", "vesicovaginal", "Fistula", and "Social Support". Inclusion criteria were primary peer reviewed articles addressing one or more study objectives, in English, on OF support, regardless of location. Two reviewers independently assessed eligibility of the studies and extracted the data. Disagreement between the reviewers were resolved by a third reviewer.Results The search resulted in 212 articles, of which 15 were included in this review. The analysis of the studies was guided by Berkman's Model. The model suggests that there is a link between social resources, social support and disease. We found that support was either internal or external. Internal support constituted self-efficacy resulting into strengthened internal locus of control. Externally, women were supported by friends and family with material and financial resources. They were also supported with education opportunities, and business start-up capital. Our review also identified the need to support women with information about OF. Most women who were successfully integrated into their communities supported other women suffering from OF.Conclusions Social networks make a significant contribution to emotional and psychological recovery of women after a successful OF surgical repair. Social networks were also found to be detrimental to emotional and psychological recovery of women. Most women were abandoned and not supported by their husbands. Only constructive surgery is not enough as OF treatment. Women need supportive and well organised social networks for them to make full recovery after OF repair.

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Section: External Supportmentioning

confidence: 99%

Social support for women after fistula repair: A scoping review

Wella

Chilemba

Namathanga

et al. 2021

Sexual & Reproductive Healthcare

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“…Twenty-one have concentrated on sex-related stigma, such as female survivors of stigma concerning sexual violence (Greiner et al 2014;Verelst et al 2014;Babalola et al 2015;Scott et al 2015;Murray et al 2018a, b;Wachter et al 2018) and male survivors, (Christian et al 2011), and HIV (Newman et al 2012;Musumari and Feldman 2013;Gebremedhin and Tesfamariam 2017;Tshingani et al 2017;Venables et al 2019). Other studies have discussed stigma related to intimate partner violence (Kohli et al 2015;Glass et al 2018), abortion (Casey et al 2019;Steven et al 2019), syphilis (Nkamba et al 2017), fistula (Young-Lin et al 2015) and contraception-use (Muanda et al 2018). A large-scale DRC-based study on maternal-child relationships of children born out of sexual violence indicated the need for interventions to reduce stigma and increase acceptance for children conceived from sexual violence and their mothers alike (Rouhani et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Understanding Stigmatisation: Results of a Qualitative Formative Study with Adolescents and Adults in DR Congo

2020

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While stigmatisation is universal, stigma research in low- and middle-income countries (LMIC) is limited. LMIC stigma research predominantly concerns health-related stigma, primarily regarding HIV/AIDS or mental illness from an adult perspective. While there are commonalities in stigmatisation, there are also contextual differences. The aim of this study in DR Congo (DRC), as a formative part in the development of a common stigma reduction intervention, was to gain insight into the commonalities and differences of stigma drivers (triggers of stigmatisation), facilitators (factors positively or negatively influencing stigmatisation), and manifestations (practices and experiences of stigmatisation) with regard to three populations: unmarried mothers, children formerly associated with armed forces and groups (CAAFAG), and an indigenous population. Group exercises, in which participants reacted to statements and substantiated their reactions, were held with the ‘general population’ (15 exercises, n = 70) and ‘populations experiencing stigma’ (10 exercises, n = 48). Data was transcribed and translated, and coded in Nvivo12. We conducted framework analysis. There were two drivers mentioned across the three populations: perceived danger was the most prominent driver, followed by perceived low value of the population experiencing stigma. There were five shared facilitators, with livelihood and personal benefit the most comparable across the populations. Connection to family or leaders received mixed reactions. If unmarried mothers and CAAFAG were perceived to have taken advice from the general population and changed their stereotyped behaviour this also featured as a facilitator. Stigma manifested itself for the three populations at family, community, leaders and services level, with participation restrictions, differential treatment, anticipated stigma and feelings of scapegoating. Stereotyping was common, with different stereotypes regarding the three populations. Although stigmatisation was persistent, positive interactions between the general population and populations experiencing stigma were shared as well. This study demonstrated utility of a health-related stigma and discrimination framework and a participatory exercise for understanding non-health related stigmatisation. Results are consistent with other studies regarding these populations in other contexts. This study identified commonalities between drivers, facilitators and manifestations—albeit with population-specific factors. Contextual information seems helpful in proposing strategy components for stigma reduction.

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Marital disruption among women with genital fistula in Nigeria: who is at greatest risk?

et al. 2018

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Healthcare providers’ perspectives on the social reintegration of patients after surgical fistula repair in the eastern Democratic Republic of Congo

Abstract: Providers view postsurgical childbearing as crucial for social reintegration after fistula repair. However, cesarean deliveries are costly and often inaccessible. More work is needed to improve reproductive health access for women after fistula repair.

Cited by 4 publications

References 19 publications

Social support for women after fistula repair: A scoping review

Social support for women after fistula repair: A scoping review

Understanding Stigmatisation: Results of a Qualitative Formative Study with Adolescents and Adults in DR Congo

Marital disruption among women with genital fistula in Nigeria: who is at greatest risk?

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