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

Lyimo, Mary A.; Mosha, Idda

doi:10.1186/s12905-019-0799-x

Cited by 19 publications

(22 citation statements)

References 20 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Under such conditions of a full-blown public health catastrophe, the mitigating effect of stronger health systems in high income countries are largely negated, so our predictions of over half a million deaths in Tanzania compare well with those of others for the United Kingdom, 29 which has a similar population size. Considering also the travel distances and household costs of hospital attendance in Tanzania [81][82][83][84] , it also raises the question as to whether severe COVID patients should be cared for in hospitals and other health facilities [85][86][87][88] which are already 52% understaffed 89 or at home [85][86][87][88] with support from a rapidly mobilized cadre of Community Health Workers, for which well-characterized curricula and training platforms already exist. [90][91][92] (1) shortening the lock down period by 3 weeks, from 15 to 12 weeks (Panels A and B), (2) reducing importation containment from 100% to 90%, (3) delaying the lock down by 3 weeks (Panels C and D), starting on week 8 rather than week 5 (Panels E and F), and (4) reducing the coverage and protective effectiveness of exposure behaviour reduction from 90% to 80% (Panels G and H).…”

Section: Even the Slightest Relaxation Of Lock Down Or Importation Comentioning

confidence: 99%

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Killeen

Kiware

2020

Preprint

View full text Add to dashboard Cite

Half the world's population is already under lock-down and the remainder will have to follow if the ongoing novel coronavirus 2019 virus pandemic is to be contained. Faced with such brutally difficult decisions, it is essential that as many people as possible understand (1) why lockdown interventions represent the only realistic way for individual countries to contain their nationallevel epidemics before they turn into public health catastrophes, (2) why these need to be implemented so early, so aggressively and for such extended periods, and (3) why international cooperation to conditionally re-open trade and travel between countries that have successfully eliminated local transmission represents the only way to contain the pandemic at global level. Here we present simplified arithmetic models of COVID-19 transmission, control and elimination in userfriendly Shiny and Excel formats that allow non-specialists to explore, query, critique and understand the containment decisions facing their country and the world at large. Based on parameter values representative of the United Republic of Tanzania, which is still early enough in its epidemic cycle and response to avert a national catastrophe, national containment and elimination with less than 10 deaths is predicted for highly rigorous lock down within 5 weeks of the first confirmed cases and maintained for 15 weeks. However, elimination may only be sustained if case importation from outside the country is comprehensively contained by isolating for three weeks all incoming travellers, except those from countries certified as COVID-free in the future. Any substantive relaxation of these assumptions, specifically shortening the lock-down period, less rigorous lockdown or imperfect importation containment, may facilitate epidemic re-initiation, resulting in over half a million deaths unless rigorously contained a second time. Removing contact tracing and isolation has minimal impact on successful containment trajectories because high incidence of similar mild symptoms caused by other common pathogens attenuates detection success of COVID-19 testing. Nevertheless, contact tracing is recommended as an invaluable epidemiological surveillance platform for monitoring and characterizing the epidemic, and for understanding the influence of interventions on transmission dynamics.

show abstract

Section: Even the Slightest Relaxation Of Lock Down Or Importation Comentioning

confidence: 99%

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Killeen

Kiware

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…12 Besides, they are often adolescents and young adults, primiparous, and peasants but in most cases they are unemployed. 9,13…”

Section: Discussionmentioning

confidence: 99%

“…The persistence of stigma, and isolation among obstetric fistula patients are indicated by several studies. 6,9,13,14 They indicate how the leakage of either urine or fecal material disrupts a woman's social status. Women with fistula have low social support, and experience comorbidities which greatly contribute to trauma.…”

Section: Challenges To the Rehabilitation Of Obstetric Fistula Patientsmentioning

confidence: 99%

“…Again, about 53% of them may live with untreated fistula for more than a year hence patients require rehabilitation as they await repair and after repair. 9 Rehabilitation refers to a set of measures aimed to assist a person with an injury or disability to achieve and maintain optimal level of functioning as they interact with the environment. It reduce the impact of various health conditions and improves functioning generally.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The persistent challenges and strategies for effective rehabilitation among obstetric fistula patients at Kitovu Mission Hospital, Uganda: a qualitative study

Atuhaire

Odukogbe

Mugisha

et al. 2020

Int J Community Med Public Health

View full text Add to dashboard Cite

Background: Obstetric fistula poses a great physical, psychosocial and economic burden to girls and women in low and middle-income countries. About 53% of the obstetric fistula patients may live with untreated fistula for more than a year, thus patients require rehabilitation as they await repair and after repair. Little qualitative research exists on rehabilitation particularly on the challenges and effective strategies that inspired this study.Methods: A cross-sectional qualitative research approach used in-depth interviews and key informant interviews to collect data from 10 obstetric fistula patients who had been registered by the Urogynecology Department, Kitovu Hospital within two years before the time of data collection status and 12 key informants who include hospital staffs engaged in the management of fistula and patients’ partners who were involved in caregiving. Data were analyzed thematically using ATLAS.ti 7.5.Results: The major constraints encountered during rehabilitation were limited resources for practice, inadequate counseling especially among immediate relatives, and inadequate capital for self-sustainability and limited employment opportunities. Key informants also mentioned the issue of limited resources, budget constraints, inadequate supervision and follow up of patients. Only one patient who had not had fistula repair had knowledge of rehabilitation. To address the challenges, the participants suggested the need for rehabilitation despite repair status. They required more knowledge about sustainable livelihood programs and cash grants.Conclusions: The patients identified socioeconomic, institutional and political challenges to their rehabilitation. They emphasized the need for improved political commitment, adequate budget, and resource allocation and regular support supervision to ensure their effective rehabilitation.

show abstract

“…6,7 Social stigma associated with having an obstetric fistula and a lack of knowledge of what caused the CONTACT Brenda Sequeira D'Mello brenda.dmello@ccbrt.or.tz CCBRT, Dar Es Salaam, Tanzania fistula are key barriers to seeking care for the condition, prolonging and exacerbating physical, socioeconomic, and psychological suffering. 8 Surgical repair of fistula is possible, but reintegration into social and work environments is also a necessary aspect of rehabilitative care. The rehabilitation is resource-intensive, further highlighting the importance of prevention of obstetric fistula through improvements in access to higher quality obstetric care.…”

Section: Overviewmentioning

confidence: 99%

Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study

Dmello¹,

Bwile

Carmone

et al. 2020

Health Systems & Reform

View full text Add to dashboard Cite

The non-governmental organization Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) developed a multi-facility maternal and neonatal Network of Care (NOC) among 22 government hospitals and catchment facilities operating across Dar es Salaam. While facility delivery rates were above 90% in the Dar es Salaam region, the quality of services was substandard, leading to an excess of preventable maternal and neonatal morbidity and mortality. In partnership with the Dar es Salaam regional health authorities CCBRT developed a plan to improve the quality of service delivery at childbirth by through a system strengthening approach, capacitating lower-level facilities to provide routine care during pregnancy and uncomplicated deliveries, as well as improving care at secondary level referral hospitals and developing an interconnected strengthened referral system. The Regional-CCBRT partnership implemented interventions across the continuum of care that included clinical training in basic and comprehensive emergency obstetric care, investments in infrastructure, and a rigorous maternal and perinatal death audit and follow-up program. Routine data generated were reflected upon at quarterly quality improvement meetings to follow up on problems identified. The government has initiated the replication of the model. This descriptive case study uses the four domains of the Networks of Care framework to document the wide-ranging efforts made to build and maintain the CCBRT Network of Care in order to solve for specific challenges in maternal and neonatal health service delivery in the urban context of the Dar es Salaam region.

show abstract

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

Cited by 19 publications

References 20 publications

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

The persistent challenges and strategies for effective rehabilitation among obstetric fistula patients at Kitovu Mission Hospital, Uganda: a qualitative study

Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study

Contact Info

Product

Resources

About