Abstract
Introduction and hypothesis
To describe the knowledge and perceptions of obstetric fistula (OF) among affected and unaffected women.
Methods
Twenty-five semi-structured interviews were conducted with women who had received OF repair. Three focus groups were conducted: one group of women with urinary incontinence but no OF, one group of women with OF, and one group of women without genitourinary complaints. Interviews and focus groups were conducted using the grounded theory approach. This study took place in two urban hospitals in Rwanda from April to November 2015. Transcripts were coded using MAXDA11 and analyzed using the axial technique and the constant comparative method.
Results
Nearly all participants correctly described OF and its symptoms, and 93% of interviewed women attributed OF to complications in vaginal delivery or cesarean section. Several participants described renouncing stigmatizing beliefs after learning about OF from the radio, health workers, or word of mouth. Still, it was found that women with OF were more knowledgeable about OF etiology than women without genitourinary conditions.
Conclusions
Compared to prior studies, women’s knowledge about OF appears to be more medically based, with media and health workers playing a role in reducing stigmatizing beliefs. These findings support continued investment in OF awareness campaigns, which seem to be increasing knowledge about OF and reducing stigma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- OF:
-
obstetric fistula
- VVF:
-
vesicovaginal fistula
- RVF:
-
rectovaginal fistula
- UI:
-
urinary incontinence
- POP:
-
pelvic organ prolapse
- LUTF:
-
lower urinary tract fistula
- RVF:
-
rectovaginal fistula
References
World Health Organization (2015) Maternal mortality ratio (modeled estimate, per 100,000 live births). http://www.who.int/mediacentre/factsheets/fs348/en/. Accessed 20 February 2016.
Lewis G, De Bernis L (2006) Obstetric fistula: guiding principles for clinical management and programme development. World Health Organization.
Mselle LT, Moland KM, Evjen-Olsen B, Mvungi A, Kohi TW. "I am nothing": experiences of loss among women suffering from severe birth injuries in Tanzania. BMC Womens Health. 2011;11(1):49.
Wall LL, Karshima JA, Kirschner C, Arrowsmith SD. The obstetric vesicovaginal fistula: characteristics of 899 patients from Jos, Nigeria. Am J Obstet Gynecol. 2004;190(4):1011–6.
Banke-Thomas AO, Kouraogo SF, Siribie A, Taddese HB, Mueller JE (2013) Knowledge of obstetric fistula prevention amongst young women in urban and rural Burkina Faso: a cross-sectional study. PloS One 8(12).
Kazaura MR, Kamazima RS, Mangi EJ (2011) Perceived causes of obstetric fistulae from rural southern Tanzania. Afr Health Sci 11(3).
Glaser B. Basics of grounded theory analysis: emergence vs forcing. Mill Valley: Sociology Press; 1992.
Corbin J, Strauss A (2014) Basics of qualitative research: Techniques and procedures for developing grounded theory. Sage publications.
Vollstedt M, Rezat S (2019) An Introduction to Grounded Theory with a Special Focus on Axial Coding and the Coding Paradigm. In: Kaiser G, Presmeg N (eds) Compendium for Early Career Researchers in Mathematics Education. ICME-13 Monographs. Springer, Cham.
Nathan LM, Rochat CH, Grigorescu B, Banks E. Obstetric fistulae in West Africa: patient perspectives. Am J Obstet Gynecol. 2009;200(5):e40–2.
Kavai MM, Chepchirchir A, Kayugira R (2010) Women's knowledge of vesico vaginal fistula in Kenya. Afr J Midwifery Womens Health 4(4).
Bangser M (2011) Making Mobile Phones Work for Women with Fistula: The M-PESA Experience in Kenya and Tanzania. EngenderHealth. https://www.fistulacare.org/wp-fcp/wp-content/uploads/pdf/technical-briefs/mobile_phone_brief_updated4.5.2011.pdf.
Baptiste D, Kapungu C, Khare MH, Lewis Y, Barlow-Mosha L. Integrating women's human rights into global health research: an action framework. J Women's Health. 2010;19(11):2091–9.
Ramsey K, Iliyasu Z, Idoko L. Fistula fortnight: innovative partnership brings mass treatment and public awareness towards ending obstetric fistula. Int J Gynecol Obstet. 2007;99:S130–6.
Acknowledgements
We acknowledge the excellent work of Arline Niarlene, MD, on the translation and transcription of study interviews. We would also like to acknowledge the International Organization for Women and Development.
Funding
Unrestricted grant from the Maren Foundation. The award did include external peer review for scientific quality of the grant.
Author information
Authors and Affiliations
Contributions
J Jiao: Data analysis, manuscript writing, manuscript editing.
R Galvao: Data analysis, manuscript writing, manuscript editing.
G Mbabazi: Project development, data collection.
B Dushimiyimana: Project development, data collection.
CCG Chen: Project development, data collection, data analysis, manuscript writing, manuscript editing.
A Long: Data analysis, manuscript writing, manuscript editing.
D Rwabizi: Project development, data collection.
E Ngoga: Project development, data collection.
PRESENTED AT: IUGA, Cape Town, South Africa, August 3, 2016.
Corresponding author
Ethics declarations
Conflict of interest
None.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Chen, C.C.G., Jiao, J., Mbabazi, G. et al. The changing perception and knowledge of obstetric fistula: a qualitative study. Int Urogynecol J 31, 2419–2425 (2020). https://doi.org/10.1007/s00192-020-04448-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-020-04448-5