Social Immersion for Women After Repair for Obstetric Fistula: An Experience in Guinea

Abstract

Background: Reintegration of women after repair of their female genital fistula remains a challenge. The objective of this study was to document the medical pathway and the reintegration process of women through the “social immersion” program of EngenderHealth in Kissidougou and Labé (Guinea).Methods: This was a qualitative descriptive study with 55 participants, including women seeking fistula care and stakeholders involved in the social immersion for repaired women in Kissidougou and Labé. The study included collecting demographic and clinical data of women, interviews with women before and after surgery, after social immersion, and 3 months post-discharge. Municipal officials, health providers, and members of host families were also interviewed. The study protocol was approved by the Guinea National Ethics Committee for Health Research.Results: The study confirmed that obstetric fistula still occurs among women living in rural and underserved areas. Most women attended at least two to five antenatal care visits, but nine over 10 reported a tragic experience of child loss associated with the occurrence of fistula. Most of them received support from their husband/partner during referral after the obstructed labor and later in the search for treatment. Women and stakeholders reported a good experience of surgery and social immersion in both Kissidougou and Labé. About 3 months after discharge, women who were continent reported being happy with their new life compared to women discharged with repair failure and residual incontinence.Conclusion: The study found the positive impacts of social immersion on the quality of life of women after fistula repair, particularly for those women who had a successful repair. The approach can be included in fistula care programs, either through direct provision or through referral to programs that can provide this service.

Psychometric Properties of Patients' Health Questionnaire Assessed on Obstetric Fistula Patients in Northwestern, Nigeria

“…These factors include prolonged obstructed labor during childbirth, particularly in areas with limited access to medical care or skilled birth attendants. In such cases, older women may be more prone to VVF due to factors like age-related changes in the pelvic anatomy, reduced tissue elasticity, or pre-existing medical conditions (Gharoro et al, 2009;Delamou et al, 2021). In this study the single/divorced women as well as widows reported significant correlation to high scores of the affective symptoms' construct of the PHQ.…”

Fertility desires and sexual behaviours among women recovering from genital fistula repair in Eldoret, Kenya

“…Post-surgical fistula repair reintegration programmes exist to support and optimise a woman's successful recovery from surgery and transition back into society, her community and the life she desires to lead. Education, job-training and safe housing are often components in these important programmes [24][25][26]. Due to possible pregnancy trauma and the culturally imposed importance of childbearing for most women recovering from having a fistula, addressing fertility desires, creating culturally sensitive family planning interventions and ensuring access to contraception may be equally as important for women's successful recovery from their fistula and continued future health.…”