Knowledge of obstetric fistula and its associated factors among women of reproductive age in Northwestern Ethiopia: a community-based cross-sectional study

Abstract

Background Obstetric fistula has been a major maternal health challenges in low and middle-income countries, especially in Ethiopia, due to high child marriage and poor access to healthcare. Obstetric fistula is common among teenage mothers that results in a vast social, economic and cultural sequel. In Ethiopia, there is a paucity of research evidence on women’s knowledge about obstetric fistula. Therefore, this study aimed to assess women’s knowledge about obstetric fistula and its associated factors at Banja District, Northwestern Ethiopia. Methods A community-based cross-sectional study design was conducted from 1st -21th July 2021. Systematic sampling method was used to recruit 784 women in the reproductive age from six rural and one urban sub-districts. Two days of training was given to research assistants regarding the objective of the study, inclusion and exclusion criteria, checking completeness and ways of protecting confidentiality. Data were collected using face-to-face interview method. Collected data were entered into EpiData and exported into SPSS version 24 for cleaning and analysis. Descriptive statistics, binary and multivariable logistic regression analysis were performed to identify associated factors. Adjusted odds ratio (AOR) at 95% CI with p < 0.05 was used to declare significant association with women’s knowledge of obstetric fistula. Results A total of 773 women gave a complete response with response rate of 98.6% (773/784). One-third (36.4%; 95%CI: 32.9-39.7%) had good knowledge about obstetric fistula. Women who had completed primary education (AOR:3.47, 95%CI:2.01–5.98), secondary and above (AOR:3.30, 95%CI:1.88–5.80), being a student (AOR: 6.78, 95%CI:3.88–11.86), get counseling about obstetric fistula (AOR:6.22, 95%CI: 3.78–10.24), participated in pregnant women’s discussion forum (AOR:3.36, 95%CI: 1.99–5.66), had antenatal care follow-up (AOR: 2.40, 95% CI: 1.39–4.13), being an urban resident (AOR: 3.19, 95% CI: 1.33–7.66), and having access to Television/Radio (AOR:1.68, 95%CI:1.10–2.60) were significantly associated with women’s good knowledge about obstetric fistula. Conclusion Women’s knowledge about obstetric fistula is unacceptably low. Therefore, concerned stakeholders should enhance awareness creation programs, strengthen antenatal care, counselling and women’s discussion forum that could substantially optimize women’s knowledge about obstetric fistula and its risk factors of obstetric fistula.

Pregnant Women`s knowledge and Attitude Regarding Obstetric Fistula

“…Also, this result was agreed with 30 who studied "Genitourinary fistulae experience in a University Teaching Hospital : a South-South Nigeria", this study found 60% of the studied sample had no idea of the cause, and other felt it was due to the will of God, iatrogenic, others felt it was due to early marriage. It is possible that due to interaction between the health care workers and the patients.…”

Variability and awareness of obstetric fistula among women of reproductive age in sub-Saharan African countries: A systematic review and meta-analysis

“…Twelve of the articles focused on communities, while the other ten dealt with facilities. Out of the 22 articles, 12 were from Ethiopia [ 31 , 32 , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] ], 2 were from Ghana [ 20 , 51 ], 2 were from Kenya [ 30 , 52 ], 2 were from Nigeria [ 33 , 53 ], 1 was from Tanzania [ 28 ], 1 was from Burkina Faso [ 5 ], 1 was from the Gambia [ 27 ], and 1 was from Uganda [ 29 ]. Seven of the studies that were selected were unpublished, while the remaining 15 studies were articles that had already been published.…”

“…It is almost entirely found in low resource regions including Sub - Saharan Africa [ 54 ]. One of the sustainable development goals is to eliminate obstetric fistulas by 2030 [ 42 , 54 ]. As a result, the study's findings will help reach Sustainable Development Goal (SDG) 3.1, which aimed to reduce the global maternal death ratio to fewer than 70 per 100,000 live births by 2030" [ 55 ].…”

“…The sub-group analysis among studies conducted in SSA revealed heterogeneity in the pooled estimates of obstetric fistula awareness across different countries in the region. Compared to a single study conducted in Gambia, which found the lowest level of awareness (12.8%) [ 27 ], studies in Tanzania yielded the highest level of pooled obstetric fistula awareness among reproductive women (61.10%) [ 28 ], followed by studies in Nigeria (53.88%) [ 33 , 53 ], Kenya (44.08%) [ 30 , 52 ], and Ethiopia (40.17%) [ 31 , 32 , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] ].…”