Reasons for delay in decision making and reaching health facility among obstetric fistula and pelvic organ prolapse patients in Gondar University Hospital, Northwest Ethiopia

Abstract

Aims: To assess reasons for the delay in getting treatment of women with obstetric fistula and pelvic organ prolapse at Gondar University Hospital.
 Methods: A hospital based cross-sectional study was conducted among 384 women. Delay was evaluated by calculating symptom onset and time of arrival to get treatment at University of Gondar Hospital. Regression analysis was conducted to elicit predictors of delay for treatment.
 Results: Of the total 384 participants 73(19.1%) were fistula cases and 311 (80.9%) were pelvic organ prolapse. The proportion of women who delayed for treatment of pelvic organ prolapse was 82.9%, and that of obstetric fistula was 60.9%. Women who had fear of disclosure due to social stigma (AOR=2; 1.03, 3.9), and financial problem (AOR=1.97; 1.01, 3.86) were associated with delay to seek treatment for pelvic organ prolapse. While increasing age (AOR =1.12; 1.01, 1.24)and divorce (AOR = 16.9; 1.75, 165.5) were associated with delay to seek treatment among obstetric fistula cases,
 Conclusions: A high proportion of women with pelvic organ prolapse and Obstetric fistula were delayed to seek treatment. Fear of disclosure due to social stigma and financial problem were the major factors that contributed for delay to seek treatment for pelvic organ prolapse. While increasing age and divorce were the predictors for delay to seek treatment for obstetrics fistula patients.

Determinants of pelvic organ prolapse at public hospitals in Hawassa city, Southern Ethiopia, 2020: unmatched case control study

“…Due to the harsh environment related to socioeconomic, geographic and institutional factors, the burden of POP has been significant in developing countries than developed countries. The incidence of POP in low and middle income countries was 19.7% with the range of 3.4%–56.4% [ 7 ]. In Nepal, more than 600,000 women suffer from POP and 200,000 women require pelvic surgery for genital prolapse [ 5 ].…”

“…POP has been a major health concern throughout the Open Access *Correspondence: bezabihterefe898@gmail.com world affecting millions of reproductive and menopause aged women with estimated lifetime prevalence of 30.0% to 50.0% [5], commonly affecting elderly and multiparous women than those under the age of 45 years (2-20% and 39.8%) covering estimated global prevalence of 2.9%-20% [6] Due to the harsh environment related to socioeconomic, geographic and institutional factors, the burden of POP has been significant in developing countries than developed countries. The incidence of POP in low and middle income countries was 19.7% with the range of 3.4%-56.4% [7]. In Nepal, more than 600,000 women suffer from POP and 200,000 women require pelvic surgery for genital prolapse [5].…”

Health-related quality of life after pelvic organ prolapse surgery in Ethiopia: A 6 month follow-up study

“…These same PRO instruments were administered postoperatively. Duration of POP symptoms denotes the number of years from the time when prolapse symptoms (feeling/seeing of vaginal bulging) rst occurred and then classi ed as delayed to seek healthcare if she stayed more than a year [34].…”

One in ten Women who visited Health Facilities for various Reason have Pelvic Organ Prolapse in Harari Regional State, Eastern Ethiopia

“…Furthermore, POP has been affecting women's health and quality of life alarmingly [22][23][24]. In Africa, large number of women with pelvic organ prolapse and obstetric stula delayed in seeking medical treatment because of the fear of disclosing the problem due to social stigma [25,26], and more than 67.7% of women with advanced POP had symptoms of depression and mental dysfunction [27,28]. In Ethiopian government has not yet developed and enrolled POP as one of maternal health indicator on demographic and health survey of the country that will help to put a separate strategy to prevent and manage POP in health sectors.…”