The changing perception and knowledge of obstetric fistula: a qualitative study

Chen, Grace; Jiao, Jie; Mbabazi, Gerard; Long, Annelise; Galvao, Rachel W.; Rwabizi, Denis; Dushimiyimana, Blaise; Ngoga, Eugene

doi:10.1007/s00192-020-04448-5

Cited by 3 publications

(3 citation statements)

References 9 publications

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“… 12 , 19 The surgical approach to managing the fistula, the characteristics of fistula patients that contribute to the formation of the fistula, their perception of the causes of the fistula, the experiences of patients following fistula surgery, and the outcomes of treatment have all been the subject of previous studies. 10 , 25–28 However, the individual and contextual factors that surround and influence the healthcare-seeking trajectories and treatment pathways of women with fistulas have not been fully investigated.…”

Section: Introductionmentioning

confidence: 99%

Understanding Healthcare-Seeking Pathways and Dilemmas Among Women with Obstetric Fistulas in Ethiopia: A Qualitative Inquiry

Hurissa¹,

Koricha²,

Dadi³

2023

IJWH

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Background Obstetric fistula is a public health problem with a damaging effect on the health of women around the world. The path to medical care is an integral part of women’s experience of illness that may have an impact on their health. Studies have addressed the experiences of patients after fistula repair, but fistula victims’ care-seeking pathways and dilemmas are still poorly understood in low-income countries, particularly Ethiopia. Objective This study aimed to explore the care-seeking pathways and dilemmas among women with fistulas in Ethiopia. Methods An exploratory phenomenological study was carried out from April 1 to August 1, 2019, through in-depth interviews and supplementary informant interviews. Data were obtained from 21 purposively selected women with fistulas who survived with morbidity for one and more years and 12 supplementary interviewees at fistula treatment centers in Oromia Region and Addis Ababa. Data were analyzed assisted by ATLAS. ti 8.4 software. Results Respondents gave their testimony that most of the women with fistulas first sought care from traditional care places and finally from fistula treatment centers. The reasons for care-seeking path dilemmas were a wrong perception about fistula, its causes, and treatment; families’ pressure and lack of decision-making power on where to seek treatment, and a lack of knowledge on where modern treatments are available for fistula. They received psychological, companionship, and transport support from a family and a community; referral and counseling support from health care providers during their care-seeking pathways. Conclusion A myriad of reasons inhibits the right care-seeking pathways among women with fistulas. Communities and women with fistula awareness creation on the right places for fistula treatment and psychological support programs are required. Additionally, developing and implementing tactics for community-level screening programs for targeted victims and early admission to treatment centers can minimize the tragic sequela of the fistula.

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Section: Introductionmentioning

confidence: 99%

Understanding Healthcare-Seeking Pathways and Dilemmas Among Women with Obstetric Fistulas in Ethiopia: A Qualitative Inquiry

Hurissa¹,

Koricha²,

Dadi³

2023

IJWH

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“…The WHO estimates that vesicouterine fistulas affect 2–3.5 million women worldwide 5. Low fistula formation of the urethra, bladder neck or mid-vagina is associated with pressure necrosis from prolonged labour.…”

Section: Introductionmentioning

confidence: 99%

“…Low fistula formation of the urethra, bladder neck or mid-vagina is associated with pressure necrosis from prolonged labour. Fistulas located in the upper urogenital tract including the vaginal apex, cervix, uterus or ureters are more likely to be associated with operative injury 5. Increasing rates of caesarean section correlate with increased fistula formation, particularly if there is direct damage to the bladder during the procedure or if the bladder is adherent to a thin lower uterine segment 6 7.…”

Section: Introductionmentioning

confidence: 99%

Omental patch for lower uterine segment repair during caesarean section

Carter

Bacq

2022

BMJ Case Rep

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Increasing rates of caesarean section have contributed to a higher number of complications such as vesicouterine fistula. A G6P5 woman in her early forties presented for her third elective repeat caesarean section. At the time of delivery, there was uterine dehiscence and the fetus was visible through a large 7×5 cm transparent window in the lower segment. After delivery of the baby, the uterus was unable to be repaired with sutures so an omental patch was fixed on the lower segment to facilitate healing. It is hypothesised that the angiogenic properties of the omentum may have promoted healing of the uterine defect and reduced the risk of vesicouterine fistula by providing a protective barrier. The patient recovered well and by 4 months post partum, her menstrual cycle had returned. Thereby, the use of an omental patch during uterine repair may reduce long-term complications associated with repeat caesarean section.

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