Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso: A Cross-Sectional Study

Abstract

Obstetric fistula is a sequela of complicated labour, which, if untreated, leaves women handicapped and socially excluded. In Burkina Faso, incidence of obstetric fistula is 6/10,000 cases amongst gynaecological patients, with more patients affected in rural areas. This study aims to evaluate knowledge on obstetric fistula among young women in a health district of Burkina Faso, comparing rural and urban communities. This cross-sectional study employed multi-stage sampling to include 121 women aged 18-20 years residing in urban and rural communities of Boromo health district. Descriptive statistics and multiple logistic regression analysis were used to compare differences between the groups and to identify predictors of observed knowledge levels. Rural women were more likely to be married (p<0.000) and had higher propensity to teenage pregnancy (p=0.006). The survey showed overall poor obstetric fistula awareness (36%). Rural residents were less likely to have adequate preventive knowledge than urban residents [OR=0.35 (95%-CI, 0.16–0.79)]. This effect was only slightly explained by lack of education [OR=0.41 (95%-CI, 0.18–0.93)] and only slightly underestimated due to previous pregnancy [OR=0.27 (95%-CI, 0.09–0.79)]. Media were the most popular source of awareness amongst urban young women in contrast to their rural counterparts (68% vs. 23%). Most rural young women became ‘aware’ through word-of-mouth (68% vs. 14%). All participants agreed that the hospital was safer for emergency obstetric care, but only 11.0% believed they could face pregnancy complications that would require emergency treatment. There is urgent need to increase emphasis on neglected health messages such as the risks of obstetric fistula. In this respect, obstetric fistula prevention programs need to be adapted to local contexts, whether urban or rural, and multi-sectoral efforts need to be exerted to maximise use of other sectoral resources and platforms, including existing routine health services and schools, to ensure sustainability of health literacy efforts.

Awareness of Obstetric Vesicovaginal Fistula among Pregnant Women in a Rural Hospital

“…If such women develop obstetric fistula during the process of childbirth, it will also become difficult for them to get treatment since they may not even be aware that it can be treated. In a study conducted in Burkina Faso among young women, 36.4% of respondents were aware of obstetric fistula [7]. Our study however showed a higher level of awareness.…”

Obstetric Fistula: The Agony of Unsafe Motherhood. A Review of Nigeria Experience

“…A study in North-Eastern Nigeria showed that 96.3% of cases of obstetric fistula had no formal education [27]. Evidence supports that knowledge and awareness on fistula amongst young women who had attained post-primary education is better in term of prevention, than women who have no education or only primary education [45]. Because of some misconceptions about the cause of fistula, it is particularly important to educate women about risks associated with early marriage and early pregnancy, including fistula, as has been implemented in Ethiopia [46].…”

Knowledge of obstetric fistula among prenatal clinic attendees and midwives in Mfantsiman municipality, Ghana

“…It puts considerable strain on the health of affected women as a result of associated fecal and/or urinary incontinence. Obstetric fistula is largely confined to low‐resource countries owing to inadequate utilization or nonavailability of maternity services . At a fistula hospital in Ethiopia, over 90% of fistula cases occurred after prolonged (duration of labor more than 1 day) or obstructed labor; the stillbirth rate was also over 90% .…”