Abstract:
Obstetric fistulae are largely preventable surgical conditions. Literature
has shown that it is common among the low income, less privileged and
marginalized members of the community. It affects mainly the poor,
young, illiterate girls, and women in the remote rural areas of the world,
where access to emergency obstetric care, family planning services and
skilled birth attendants are unavailable. And when available are poorly
utilized due to cost, distance, and other challenges. This study seeks to
identify the social features and morbidity characteristics of obstetric
fistulae in women at the fistula center in Bingham University Teaching
Hospital, Jos, Plateau State, Nigeria. This was a descriptive study done in
2019 among all the patients who attended the obstetric fistula Centre at
Bingham University Teaching Hospital. An Interviewer-administered
structured questionnaire was used, and it looked at social and health
aspects of obstetric fistulae in all 49 patients at the center. Data was
analyzed using a computer software; Statistical Package for the Social
Science (SPSS) version 20.0. Most of patients had some form of financial
support especially from family members, husbands, parents, and friends.
Most of the women had their relationships affected. Majority were
separated, and relationships strained and had lost financial support from
their spouses. Sexual Intercourse was adversely affected. On surgical
outcome, 16% became completely dry and leaking had ceased, a third
(36.7%) was still leaking urine after the surgery. Almost all the women
have had no childbirth after the repair. Women had mental health issues
like depression, anxiety, tension headache, fatigue, and suicidal ideation.
Participants also had gynaecological morbidities like vulval dermatitis,
irregular menstrual flow, abnormal vaginal discharge, and dysuria. These
women also had lower abdominal pains, loss of weight, backache, and foot
drop. Majority of the children did not survive after the pregnancy that led
to the obstetric fistula. Women should seek financial support from family
members to avoid delays in seeking help during pregnancy. Communities
are encouraged to continue to give moral, emotional, financial, and social
support to fistula patients. Healthcare workers should take advantage of
the fact that most women attended ANC to educate and enlighten
pregnant women on causes, risk factors, social and health consequences of
obstetric fistulae. Government should initiate poverty alleviation activities
and help reduce out of pocket expenses for healthcare via health
insurance.
