Experiences of women seeking medical care for obstetric fistula in Eritrea: Implications for prevention, treatment, and social reintegration

Abstract

This article presents findings from qualitative interviews with women seeking medical care for obstetric fistula in Eritrea. The interviews were designed to inform programme design for the prevention and treatment of obstetric fistula. Interviews were conducted with 11 new fistula repair patients, 15 women returning for follow-up for their fistula repairs, and five accompanying family members at Massawa Hospital in the Northern Red Sea Zone of Eritrea during November-December 2004. The women described long delays in accessing emergency obstetric care due to delayed recognition of the seriousness of the problem and lack of transportation from remote villages. Follow-up patients described improvements in their conditions, but many continued to have problems with incontinence and sexual health. Both new and returning patients lacked specific information about their condition, what to expect in terms of treatment and recovery, and how to care for themselves. The findings point to a need for community mobilization and education on safe motherhood for prevention of fistula, as well as for improved information, counselling, follow-up, and social services for women who develop obstetric fistulas.

Consequences of obstetric fistula in sub Sahara African countries, from patients’ perspective: a systematic review of qualitative studies

“…All included studies were conducted in Sub-Saharan Africa: two in Ethiopia [21, 22], five in Tanzania [11, 13, 23–25], one in Uganda and Tanzania [11], one in Eritrea [16], two in Uganda [26, 27] two in Nigeria [19, 28], one in Kenya [29],one in Ghana [30], and one in Malawi [31]. All research took place in treatment or rehabilitation facilities, except reports from Kenya and Malawi which were conducted in the community.…”

“…Physical consequence was the core theme shared across most studies, described as loss of body control and the challenges faced to keep cleanness [13, 16, 19, 24, 28, 29, 32]. Physical challenges include the emotional and medical problems of fistula which resulted from incontinence, such as genital sores, smells, wounds, pain, discomfort, exhaustion, and foot drop [21].…”

“…The consequence of obstetric fistula is devastating for those affected women and their families [14, 15]. Beyond the medical conditions, the social consequences are severe, and affected women are often ostracized from their community, divorced, abandoned, and remain childless [16, 17]. Women living with fistula may be blamed by the community members for their condition, viewing it as punishment for sin or a venereal disease or curse [17].…”

Profiles and experiences of women undergoing genital fistula repair: Findings from five countries

“…Published accounts have found that many women and their families fail to recognise danger signs that necessitate skilled attendance at delivery or experience delays in seeking care due to lack of transportation or funds for transport; some experience delays once they reach the facility due to lack of providers, supplies, or equipment (Bangser et al, 2010; Holme, Breen, & MacArthur, 2007; Mselle, Kohi, Mvungi, Evjen-Olsen, & Moland, 2011a; Turan, Johnson, & Polan, 2007). …”

Community awareness about risk factors, presentation and prevention and obstetric fistula in Nabitovu village, Iganga district, Uganda

“…Awareness of obstetric fistula is still low in many developing countries where it is prevalent [23]. In Uganda, an estimated 2.6% (about 142,000 women) of reproductive age nationally have experienced obstetric fistula [22].…”