Obstetric fistulae in West Africa: patient perspectives

Nathan, Lisa M.; Rochat, Charles-Henry; Grigorescu, Bogdan; Banks, Erika

doi:10.1016/j.ajog.2008.10.014

Cited by 43 publications

(28 citation statements)

References 4 publications

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“…All study measures were administered to both study groups orally, given the documented low literacy of obstetric fistula patients [34]. Since most measures used Likert scales for response options, a visual representation of the scaled response options was devised [35].…”

Section: Methodsmentioning

confidence: 99%

Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania

et al. 2015

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Background Obstetric fistula is a childbirth injury prevalent in sub-Saharan Africa that causes uncontrollable leaking of urine and/or feces. Research has documented the social and psychological sequelae of obstetric fistula, including mental health dysfunction and social isolation. Purpose This cross-sectional study sought to quantify the psychological symptoms and social support in obstetric fistula patients, compared with a patient population of women without obstetric fistula. Methods Participants were gynecology patients (N = 144) at the Kilimanjaro Christian Medical Center in Moshi, Tanzania, recruited from the Fistula Ward (n = 54) as well as gynecology outpatient clinics (n = 90). Measures included previously validated psychometric questionnaires, administered orally by Tanzanian nurses. Outcome variables were compared between obstetric fistula patients and gynecology outpatients, controlling for background demographic variables and multiple comparisons. Results Compared to gynecology outpatients, obstetric fistula patients reported significantly higher symptoms of depression, posttraumatic stress disorder, somatic complaints, and maladaptive coping. They also reported significantly lower social support. Conclusions Obstetric fistula patients present for repair surgery with more severe psychological distress than gynecology outpatients. In order to address these mental health concerns, clinicians should engage obstetric fistula patients with targeted mental health interventions.

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Section: Methodsmentioning

confidence: 99%

Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania

et al. 2015

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“…All participants completed a structured survey prior to receiving surgical fistula repair. Due to the high prevalence of illiteracy in obstetric fistula patients (Nathan, Rochat, Grigorescu, & Banks, 2009), the survey was administered orally in Kiswahili by a female Tanzanian interviewer.…”

Section: Methodsmentioning

confidence: 99%

Religious coping among women with obstetric fistula in Tanzania

Watt

Wilson

Joseph

et al. 2014

Global Public Health

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Religion is an important aspect of Tanzanian culture, and is often used to cope with adversity and distress. This study aimed to examine religious coping among women with obstetric fistulae. Fifty-four women receiving fistula repair at a Tanzanian hospital completed a structured survey. RCOPE assessed positive and negative religious coping strategies. Analyses included associations between negative religious coping and key variables (demographics, religiosity, depression, social support and stigma). Forty-five women also completed individual in-depth interviews where religion was discussed. Although participants utilised positive religious coping strategies more frequently than negative strategies (p<.001), 76% reported at least one form of negative religious coping. In univariate analysis, negative religious coping was associated with stigma, depression and low social support. In multivariate analysis, only depression remained significant, explaining 42% of the variance in coping. Qualitative data confirmed reliance upon religion to deal with fistula-related distress, and suggested that negative forms of religious coping may be an expression of depressive symptoms. Results suggest that negative religious coping could reflect cognitive distortions and negative emotionality, characteristic of depression. Religious leaders should be engaged to recognise signs of depression and provide appropriate pastoral/spiritual counseling and general psychosocial support for this population.

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“…Measures for improvement of health-system's response to emergency obstetric care by improving access, and providing safe and timely intervention for women presenting with obstructed labour have been suggested in the literature. Ensuring that the care provided by health workers is affordable, safe and timely for women in need of care is important, especially for women in the most deprived settings [47][48][49]. Previous studies showed that while 83% of women in urban areas delivered their babies in health facilities, 80% of rural women gave birth at home [50].…”

Section: Recommendationsmentioning

confidence: 99%

Obstetric Fistula: The Agony of Unsafe Motherhood. A Review of Nigeria Experience

Njoku

2019

JAMMR

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Obstetric fistula is a dehumanizing complication of childbirth that has severe psychosocial impact; though almost non-existing in developed nations, it is still a public health problem in Nigeria and other countries in sub-Saharan Africa. In Nigeria, about 100,000–1,000,000 women are living with obstetric fistula and estimated 50,000-100,000 new cases occur annually. To review the relevant literature on obstetric fistula in Nigeria, literature search was carried on epidemiology, prevalence, risk factors, causes, reasons for delay in intervention, complications and preventions using Google search. Additional information was obtained from text and journal in medical library of University of Calabar library. The main cause of obstetric fistula in Nigeria is prolonged obstructed labour, which most often occur due to delay in seeking medical attention because of social and financial reasons. Other causes include inadequate facilities for emergency obstetric services, especially caesarean section, poor access to existing ones, and delay in intervention on reaching the health facilities as a result of limited number of skilled obstetric personnel and/or equipments. There is need to increase collaboration and education of local communities on the cultural and social factors that influence and increase risk of obstetric fistula as well as improving the health-system’s response to emergency obstetric care.

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Obstetric fistulae in West Africa: patient perspectives

Cited by 43 publications

References 4 publications

Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania

Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania

Religious coping among women with obstetric fistula in Tanzania

Obstetric Fistula: The Agony of Unsafe Motherhood. A Review of Nigeria Experience

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