Living with Obstetric Fistula: Perceived Causes, Challenges and Coping Strategies among Women Attending the Fistula Clinic at Mulago Hospital, Uganda
Joan Kabayambi *
Makerere University School of Public Health/Centers for Disease Control and Prevention Fellow Attached to Centre for Health Human Rights and Development, Uganda.
Justus Kafunjo Barageine
Department of Obstetrics and Gynecology Mulago Hospital, Uganda.
Joseph K. B. Matovu
Makerere University School of Public Health, Uganda.
Jolly Beyeza
Department of Obstetrics and Gynecology Mulago Hospital, Uganda.
Elizabeth Ekirapa
Makerere University School of Public Health, Uganda.
Rhoda K. Wanyenze
Makerere University School of Public Health, Uganda.
*Author to whom correspondence should be addressed.
Abstract
Aims: To determine perceived causes, challenges and coping mechanisms of women living with obstetric fistula (OF) in Uganda.
Study Design: Cross-sectional study.
Place and Duration of the Study: Mulago National Referral Hospital Uganda – January to July 2009.
Methodology: Thirty women with OF were interviewed on challenges, coping 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.
Keywords: Obstetric fistulae, Obstetric fistulae challenges, coping, perceived causes, misconceptions, Uganda