Living with Obstetric Fistula: Perceived Causes, Challenges and Coping Strategies among Women Attending the Fistula Clinic at Mulago Hospital, Uganda

Abstract

Authors' contributions This work was carried out in collaboration between all authors. Author JK designed the protocol, collected the data, wrote the first complete draft of this paper and was responsible for final submission of the paper. Author JKB supervised the design of the protocol and data collection; reviewed the first draft of the paper and improved it for substantial intellectual content. Authors JKBM and JB participated in data analysis, interpretation of data and manuscript writing and reviewed the paper for substantial intellectual content. Author EK participated in manuscript writing, made substantial comments to the revised version of the paper, and improved it for substantial intellectual content. Author RKW participated in data analysis, interpretation of data and manuscript writing; reviewed the paper for substantial intellectual content. All authors read and approved the final version of the manuscript. ABSTRACT Aims: To determine perceived causes, challenges and coping mechanisms of women living with obstetric fistula (OF) in Uganda. 353 mechanisms and perceived causes of OF using semi-structured questionnaires. Two focus group discussions were held with 10 caretakers of the women with OF and key informant interviews with 10 health care providers. Results: Majority of the women (21; 70%) were young (<25 years) had primary education (20; 67%) and had lived with OF for 2-9 years (20; 67%). The main perceived causes of OF were injury by surgeon (8; 27%), delivery of a big baby (7; 23%) and prolonged labor (4; 13%). Nearly all women with OF (27; 90%) reported that OF had detrimentally affected their health and well being; 26 women (87%) lost their children at birth or within the neonatal period. Families were affected by high cost of treatment (13; 43%); provision of basic items (10; 32%), and suffered stress (17; 55%). Women coped with OF by hiding from the general public (27; 90%), maintaining strict hygiene (25; 83%), ignoring people's comments (23; 75%) or resorting to prayer (18; 57%). Conclusion: Women with OF experienced physical, emotional and socio-economic challenges and coped with OF through non-effective social measures. There is need to strengthen strategies to prevent OF and enhance OF rehabilitation services for affected women and their families.