Experiences of social support among women presenting for obstetric fistula repair surgery in Tanzania

Dennis, Alexis C.; Wilson, Sarah M.; Mosha, Mary Vincent; Masenga, Gileard; Sikkema, Kathleen J.; Terroso, Korrine E; Watt, Melissa H.

doi:10.2147/ijwh.s110202

Cited by 27 publications

(16 citation statements)

References 29 publications

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“…Notably, some of the more recent papers respond to the historically dominant narrative describing the heavy stigma women with obstetric fistula face by depicting contrasting experiences [47,88,89]. For example, in their study in Tanzania, Dennis et al [47] emphasize the helpful roles that the wider family plays for many women, even when husbands are not supportive. They also found that problems with husbands frequently predated the fistula, and were not the result of the morbidity alone.…”

Section: Resultsmentioning

confidence: 99%

What maternal morbidities are and what they mean for women: A thematic analysis of twenty years of qualitative research in low and lower-middle income countries

et al. 2019

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Background With an estimated 27 million annual incidents of maternal morbidity globally, how they are manifested or experienced is diverse and shaped by societal, cultural and personal influences. Using qualitative research to examine a woman's perception of her pregnancy, its complications, and potential long-term impact on her life can inform public health approaches and complement and inform biomedical classifications of maternal morbidities, historically considered a neglected dimension of safe motherhood. As part of the WHO’s Maternal Morbidity Working Group’s efforts to define and measure maternal morbidity, we carried out a thematic analysis of the qualitative literature published between 1998 and 2017 on how women experience maternal morbidity in low and lower-middle income countries. Results and conclusions Analysis of the 71 papers included in this study shows that women’s status, their marital relationships, cultural attitudes towards fertility and social responses to infertility and pregnancy trauma are fundamental to determining how they will experience morbidity in the pregnancy and postpartum periods. We explore the physical, economic, psychological and social repercussions pregnancy can produce for women, and how resource disadvantage (systemic, financial and contextual) can exacerbate these problems. In addition to an analysis of ten themes that emerged across the different contexts, this paper presents which morbidities have received attention in different regions and the trends in researching morbidities over time. We observed an increase in qualitative research on this topic, generally undertaken through interviews and focus groups. Our analysis calls for the pursuit of high quality qualitative research that includes repeat interviews, participant observation and triangulation of sources to inform and fuel critical advocacy and programmatic work on maternal morbidities that addresses their prevention and management, as well as the underlying systemic problems for women’s status in society.

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Section: Resultsmentioning

confidence: 99%

What maternal morbidities are and what they mean for women: A thematic analysis of twenty years of qualitative research in low and lower-middle income countries

et al. 2019

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“…Female genital fistula is often a direct result of inadequate obstetric health services for women with obstructed labor; congenital, iatrogenic, and genital trauma represent other less frequent causes . Women with fistula suffer physical, socioeconomic, and psychological consequences and experience a high level of disability, which further limits their access to adequate health services and skilled surgical care . The Democratic Republic of Congo (DRC) is a country characterized by weak maternal health indicators; the World Bank reports a fertility rate of 6 births per woman and a maternal mortality ratio of 550 per 100 000 live births .…”

Section: Introductionmentioning

confidence: 99%

The mobile surgical outreach program for management of patients with genital fistula in the Democratic Republic of Congo

Maroyi

Keyser²,

Hosterman³

et al. 2020

Intl J Gynecology & Obste

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Objective: To describe components of the mobile surgical outreach (MSO) program as a model of care delivery for women with genital fistula; present program results; and discuss operational strengths and challenges. Methods: A retrospective observational study of routinely collected health data from women treated via the MSO program (2013-2018). The program was developed at Panzi Hospital in the Democratic Republic of Congo to meet the needs of women with fistula living in remote provinces, where travel is prohibited. It includes healthcare delivery, medico-surgical training, and community sensitization components. Results: The MSO team cared for 1517 women at 41 clinic sites across 18 provinces over the study period. Average age at presentation was 31 years (range, 1-81 years). Most women (n=1359, 89.6%) presented with vesicovaginal fistula. Most surgeries were successful, and few women reported residual incontinence postoperatively. Local teams were receptive and engaged in clinical skills training and public health education efforts. Conclusion:The MSO program addresses the backlog of patients awaiting fistula surgery and provides a template for a national strategic plan to treat and ultimately end fistula in DRC. It offers a patient-centered approach that brings medico-surgical care and psychosocial support to women with fistula in their own communities.

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“…The Tanzanian government has attempted to identify all girls and women with untreated fistula and refer them to healthcare facilities for free surgical repair [11]. Repair of fistula is recommended within 3 months of woman first experiencing fistula symptoms; if women delay seeking treatment for more than 3 months, the condition tends to be difficult to repair and results in more delay in healing and possible reoccurrence of fistula [12, 13]. Surgical fistula repair has a success rate of up to 90% and has been shown to have a positive impact on women’s lives by improving their economic status, physical condition and interpersonal relationships [12].…”

Section: Introductionmentioning

confidence: 99%

Reasons for delay in seeking treatment among women with obstetric fistula in Tanzania: a qualitative study

Lyimo

Mosha

2019

BMC Women's Health

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Background: Obstetric fistula is among the serious and distressing maternal morbidities in Tanzania. Obstetric fistula is a childbirth-related injury caused by prolonged and obstructed labor which has a devastating impact on affected women and their families. The aim of this study was to explore reasons why women with obstetric fistula admitted to the Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT) hospital delayed seeking fistula treatment. Methods: This exploratory study incorporated qualitative approach. In-depth interviews were used to collect data from 18 women with obstetric fistula admitted to CCBRT hospital. The interviews were conducted in Kiswahili and lasted for 40-45 min. Audio-recordings of the interviews were transcribed verbatim and translated into English. Thematic analysis was used to extract reasons for the delay in seeking treatment for obstetric fistula. Results: The study sample (n = 18) ranged in age from 20 to 57 (μ = 37; SD = 11.67), married (n = 14), unemployed (n = 15), and very low level education (n = 15) with primary education. Delay in seeking treatment for obstetric fistula was related to the following themes: inadequate knowledge about the causes and treatment of obstetric fistula, distance and transport cost to a health facility, stigma, community isolation, social isolation and use of traditional and cultural. Conclusion: The Tanzanian Ministry of Health in collaboration with private institutions should strengthen education programmes on the nature and causes of obstetric fistula, and increase the availability of treatment to decrease the effect of this condition for women in Tanzania.

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Experiences of social support among women presenting for obstetric fistula repair surgery in Tanzania

Cited by 27 publications

References 29 publications

What maternal morbidities are and what they mean for women: A thematic analysis of twenty years of qualitative research in low and lower-middle income countries

What maternal morbidities are and what they mean for women: A thematic analysis of twenty years of qualitative research in low and lower-middle income countries

The mobile surgical outreach program for management of patients with genital fistula in the Democratic Republic of Congo

Reasons for delay in seeking treatment among women with obstetric fistula in Tanzania: a qualitative study

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