Long-Term Effects of Obstetric Fistula on the Overall Quality of Life among Survivors Who Had Undergone Obstetric Fistula Repair, Central Gondar Zone, Northwest Ethiopia, 2020: A Community-Based Study

Abstract

Introduction. Childbirth is a special time in the lives of women and families at large. It can also be a time of great tragedy. International reports show that, annually, more than 500,000 women die from pregnancy and childbirth complications globally. For every woman who dies in childbirth, majorities remain alive, but scarred by permanent disabilities. Obstetric fistula is, without a doubt, the most severe of pregnancy-related disabilities. Objective. This research is aimed at assessing the long-term effects of obstetric fistula on the overall quality of life among fistula survivors in central Gondar zone. Methods. A community-based cross-sectional study was conducted among women who had undergone obstetric fistula repair, 1-4 years after the surgery, in the central Gondar zone. The participants were reached through appointments that were made by the researchers using census approach after having the participants’ contact lists (specific residence and cell phone numbers), and research interviews have taken place at the respondents’ home or residence using an adapted and validated tool. Data entry and analysis were done using Epi Info version 7 and SPSS version 20, respectively. Results. A total of 182 fistula survivors were interviewed giving a 94.8% response rate. This study indicated that 84.1% (95% CI: 78.8, 89.4) of respondents had a poor overall quality of life. Maternal age (>30 years) ( AOR = 3.8 , 95% CI: 2.6, 12.3), marital status (divorced survivors) ( AOR = 2.7 , 95% CI: 1.3, 8.5), and urinary incontinence ( AOR = 1.9 , 95% CI: 2.4, 11.2) were positive predictors for poor overall quality of life. The majority of fistula survivors, 82.4%, were stigmatized which could make reintegration into the community challenging for them. Healthcare providers have to implement counseling to women for social reintegration and the possibility of gainful societal activities after repairing.

“I became a person again”: Social inclusion and participation experiences of Ethiopian women post-obstetric fistula surgical repair

“…In our study, most women were divorced, which is consistent with previous OF research in Nigeria, Ghana, and Ethiopia [ 39 – 41 ]. While most divorces in our study occurred before surgical intervention, aligning with prior OF studies in Ethiopia and Uganda, in some cases, divorce followed successful surgical correction, not necessarily due to OF but rather other sexual and reproductive health issues, such as infertility [ 34 , 41 , 42 ]. Researchers in Tanzania and Malawi have documented ongoing sexual and reproductive health issues post-OF surgery, including infertility and sexual dysfunction [ 40 , 43 ].…”

Life Experiences on Social and Economic Re-Integration for Fistula Victims Post Repair, Tanzania

“…Due to this, immediate embrace of women following surgery is not easy (13). To address this, the project in Tanzania conducted seminars, campaigns, advocacy and counselling sessions to families and communities where the survivors came from.…”

Proportions and determinants of successful surgical repair of obstetric fistula in low- and middle-income countries: A systematic review and meta-analysis

“…Analysis of data from six studies [18,36,44,52,62,69] showed that married women were 44% more likely to have a successful surgical repair of obstetric fistula than their single counterparts. The positive impact of marital status on successful outcome might be justified by a husband's psychological and financial support, as indicated by studies that investigated the quality of life following the surgical repair of obstetric fistula patients [110][111][112]. However, none of the included studies demonstrate a significant association, clearly implying that a repeat study involving a large number of participants should be performed to investigate whether marital status determines the success of surgical repair of obstetric fistula.…”