Qualitative assessment of knowledge, determinants and the consequences of obstetric fistula among patients and caregivers in a tertiary hospital in North Central Nigeria

Abstract

Introduction: Obstetric fistula is an entirely preventable condition that can be caused by obstructed labour, caesarean section, advanced cervical cancer, and uterine rupture. It is commonly found among poor and illiterate rural women. This study assessed the knowledge of obstetric fistula among patients and relatives, the determinants of maternal healthcare utilization and the health, psychological and economic consequences of obstetric fistula. Methods: This qualitative study was conducted in the Fistula Centre of Bingham University Teaching Hospital, Jos, Plateau State. This study utilized Focus Group Discussions among 40 patients and relatives of obstetric fistula patients. Results: Causes of obstetric fistula as stated by most respondents include prolonged labour, home deliveries, caesarean section, delay in seeking care, early parity, and high parity. Relatives stated that prevention of obstetric fistula can be achieved by creation of referral services to bigger hospitals in complicated deliveries, health education/empowerment of the girl child, encouragement of spouses and family members to give support for ANC and delivery services. A fifth of respondents do not utilize maternal health services due to lack of transportation, and all respondent needed to inform their spouse before seeking maternal care. Patients suffered significant health, psychosocial and economic sequalae like isolation and rejection, shame, depression, divorce, low income, and other morbidities. Conclusion: Perceived possible causes of obstetric fistula were prolonged labour, home deliveries, caesarean section, delay in seeking care, early parity and high parity. Patients had Significant health, psychosocial and economic sequalae like isolation and rejection, shame, depression, divorce, low income and other morbidities are possible consequences of the condition.