Skip to main content
Top
Published in: International Urogynecology Journal 6/2013

01-06-2013 | Original Article

Silently waiting to heal

Experiences among women living with urinary incontinence in northwest Ethiopia

Authors: Janne L. Gjerde, Guri Rortveit, Mulu Muleta, Astrid Blystad

Published in: International Urogynecology Journal | Issue 6/2013

Login to get access

Abstract

Introduction and hypothesis

The aim of this study was to gain in-depth knowledge of women suffering from urinary incontinence (UI) in rural and semiurban settings in Ethiopia.

Methods

A qualitative study based on semistructured in-depth interviews with 26 informants, 18 of whom were women experiencing the symptom of urinary leakage. The study was conducted in the Amhara Region of northwest Ethiopia and was part of the Dabat Incontinence and Prolapse (DABINCOP) study.

Results

Limited access to water, soap, pads, and spare clothes characterized daily management of the symptom. The consequences for marital relationships and social life were of great concern to the informants. Shame, embarrassment, and fear of being discriminated against led to huge efforts to hide the leakage. Among informants who were not able to hide it, humiliating comments and discriminatory behavior were commonly experienced, sometimes leading to divorce and self-isolation. Women who disclosed their symptom usually had a person who supported them. Women with UI regarded it as unnatural and uncommon. Most took no action to improve the situation, as they saw no options for help.

Conclusions

Several circumstances limited the opportunities available to women to keep themselves clean, disclose the problem to others, and access health information and health-care facilities. In order to understand how women in this setting practically handled, perceived, and experienced living with UI, it was essential to address contextualized and sociocultural dimensions related to the symptom.
Literature
1.
go back to reference Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26PubMedCrossRef Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26PubMedCrossRef
2.
go back to reference Hannestad YS, Rortveit G, Sandvik H, Hunskaar S (2000) A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. J Clin Epidemiol 53:1150–1157PubMedCrossRef Hannestad YS, Rortveit G, Sandvik H, Hunskaar S (2000) A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. J Clin Epidemiol 53:1150–1157PubMedCrossRef
3.
go back to reference Hampel C, Artibani W, Espuna Pons M, Haab F, Jackson S, Romero J et al (2004) Understanding the burden of stress urinary incontinence in Europe: a qualitative review of the literature. Eur Urol 46:15–27PubMedCrossRef Hampel C, Artibani W, Espuna Pons M, Haab F, Jackson S, Romero J et al (2004) Understanding the burden of stress urinary incontinence in Europe: a qualitative review of the literature. Eur Urol 46:15–27PubMedCrossRef
4.
go back to reference Chaliha C, Stanton SL (1999) The ethnic cultural and social aspects of incontinence - a pilot study. Int Urogynecol J Pelvic Floor Dysfunct 10:166–170PubMedCrossRef Chaliha C, Stanton SL (1999) The ethnic cultural and social aspects of incontinence - a pilot study. Int Urogynecol J Pelvic Floor Dysfunct 10:166–170PubMedCrossRef
5.
go back to reference Hayder D, Schnepp W (2010) Experiencing and managing urinary incontinence: a qualitative study. West J Nurs Res 32:480–496PubMedCrossRef Hayder D, Schnepp W (2010) Experiencing and managing urinary incontinence: a qualitative study. West J Nurs Res 32:480–496PubMedCrossRef
6.
go back to reference Lagro-Janssen T, Smits A, Van Weel C (1992) Urinary incontinence in women and the effects on their lives. Scand J Prim Health Care 10:211–216PubMedCrossRef Lagro-Janssen T, Smits A, Van Weel C (1992) Urinary incontinence in women and the effects on their lives. Scand J Prim Health Care 10:211–216PubMedCrossRef
7.
go back to reference Peake S, Manderson L, Potts H (1999) "Part and parcel of being a woman": female urinary incontinence and constructions of control. Med Anthropol Q 13:267–285PubMedCrossRef Peake S, Manderson L, Potts H (1999) "Part and parcel of being a woman": female urinary incontinence and constructions of control. Med Anthropol Q 13:267–285PubMedCrossRef
8.
go back to reference Subak LL, Brown JS, Kraus SR, Brubaker L, Lin F, Richter HE et al (2006) The "costs" of urinary incontinence for women. Obstet Gynecol 107:908–916PubMedCrossRef Subak LL, Brown JS, Kraus SR, Brubaker L, Lin F, Richter HE et al (2006) The "costs" of urinary incontinence for women. Obstet Gynecol 107:908–916PubMedCrossRef
9.
go back to reference Walker GJ, Gunasekera P (2011) Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J 22:127–135PubMedCrossRef Walker GJ, Gunasekera P (2011) Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J 22:127–135PubMedCrossRef
10.
go back to reference Komorowski L, Chen B (2006) Female urinary incontinence in China: experiences and perspectives. Health Care Women Int 27:169–181PubMedCrossRef Komorowski L, Chen B (2006) Female urinary incontinence in China: experiences and perspectives. Health Care Women Int 27:169–181PubMedCrossRef
11.
go back to reference Wilkinson K (2001) Pakistani women's perceptions and experiences of incontinence. Nurs Stand 16:33–39PubMed Wilkinson K (2001) Pakistani women's perceptions and experiences of incontinence. Nurs Stand 16:33–39PubMed
12.
go back to reference El-Azab AS, Mohamed EM, Sabra HI (2007) The prevalence and risk factors of urinary incontinence and its influence on the quality of life among Egyptian women. Neurourol Urodyn 26:783–788PubMedCrossRef El-Azab AS, Mohamed EM, Sabra HI (2007) The prevalence and risk factors of urinary incontinence and its influence on the quality of life among Egyptian women. Neurourol Urodyn 26:783–788PubMedCrossRef
13.
go back to reference Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348:900–907PubMedCrossRef Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348:900–907PubMedCrossRef
14.
go back to reference Rortveit G, Hannestad YS, Daltveit AK, Hunskaar S (2001) Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol 98:1004–1010PubMedCrossRef Rortveit G, Hannestad YS, Daltveit AK, Hunskaar S (2001) Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol 98:1004–1010PubMedCrossRef
15.
go back to reference Ethiopia Demographic and Health Survey (2011) Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International Ethiopia Demographic and Health Survey (2011) Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International
17.
go back to reference Onsembe JO (2005) Country situation analysis. Ethiopia: situation analysis on population, reproductive health and gender. UNFPA Country Technical Services Team, Addis Ababa, Ethiopia Onsembe JO (2005) Country situation analysis. Ethiopia: situation analysis on population, reproductive health and gender. UNFPA Country Technical Services Team, Addis Ababa, Ethiopia
19.
go back to reference Central Statistical Agency (2007) The 2007 Population and Housing Census of Ethiopia: Statistical Report for Amhara Region; Part I: Population Size and Characteristics. Addis Ababa, Ethiopia Central Statistical Agency (2007) The 2007 Population and Housing Census of Ethiopia: Statistical Report for Amhara Region; Part I: Population Size and Characteristics. Addis Ababa, Ethiopia
20.
go back to reference Megabiaw B, Adefris M, Rortveit G, Degu G, Muleta M, Blystad A, Kiserud T, Melese T, Kebede Y (2012) Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J. doi:10.1007/s00192-012-1981-y Megabiaw B, Adefris M, Rortveit G, Degu G, Muleta M, Blystad A, Kiserud T, Melese T, Kebede Y (2012) Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J. doi:10.​1007/​s00192-012-1981-y
21.
go back to reference Malterud K (2003) Kvalitative metoder i medisinsk forskning (Qualitative methods in medical research). Universitetsforlaget, Oslo Malterud K (2003) Kvalitative metoder i medisinsk forskning (Qualitative methods in medical research). Universitetsforlaget, Oslo
22.
go back to reference Kleinman A (1988) The personal and social meanings of illness. In: Kleinman A (ed) The illness narratives: suffering, healing, and the human condition. Basic Books, New York, pp 31–55 Kleinman A (1988) The personal and social meanings of illness. In: Kleinman A (ed) The illness narratives: suffering, healing, and the human condition. Basic Books, New York, pp 31–55
23.
go back to reference Hodes R (1997) Cross-cultural medicine and diverse health beliefs. Ethiopians abroad. West J Med 166:29–36PubMed Hodes R (1997) Cross-cultural medicine and diverse health beliefs. Ethiopians abroad. West J Med 166:29–36PubMed
24.
go back to reference Anderson L (2007) Faith as a means of healing: traditional medicine and the ethiopian orthodox church in and around Lalibela. Villanova University, Pennsylvania Anderson L (2007) Faith as a means of healing: traditional medicine and the ethiopian orthodox church in and around Lalibela. Villanova University, Pennsylvania
25.
go back to reference Farmer P (2004) An anthropology of structural violence. Curr Anthropol 45:305–325CrossRef Farmer P (2004) An anthropology of structural violence. Curr Anthropol 45:305–325CrossRef
26.
go back to reference Scheper-Hughes N (2004) Dangerous and endangered youth: social structures and determinants of violence. Ann N Y Acad Sci 1036:13–46PubMedCrossRef Scheper-Hughes N (2004) Dangerous and endangered youth: social structures and determinants of violence. Ann N Y Acad Sci 1036:13–46PubMedCrossRef
27.
go back to reference Singer M (2004) Critical medical anthropology. Encyclopedia of medical anthropology: Health and illness in the world´s cultures 1:23–30 Singer M (2004) Critical medical anthropology. Encyclopedia of medical anthropology: Health and illness in the world´s cultures 1:23–30
28.
go back to reference Alemu B (2008) Early marriage in Ethiopia: causes and health consequences. Exchange on HIV and AIDS, Sexuality and Gender 1:4–6 Alemu B (2008) Early marriage in Ethiopia: causes and health consequences. Exchange on HIV and AIDS, Sexuality and Gender 1:4–6
Metadata
Title
Silently waiting to heal
Experiences among women living with urinary incontinence in northwest Ethiopia
Authors
Janne L. Gjerde
Guri Rortveit
Mulu Muleta
Astrid Blystad
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 6/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-012-1951-4

Other articles of this Issue 6/2013

International Urogynecology Journal 6/2013 Go to the issue