Abstract
Introduction and hypothesis
Authors sought evidence from the testimonies of women living with fistula regarding local risk factors for fistula and the impact of fistula on women's lives.
Methods
One hundred thirty-seven women recruited from health facilities and at the community level in Tanzania and Uganda were interviewed using quantitative and qualitative methods, including participatory approaches.
Results
Women of all ages and parities endured fistula. The testimonies illustrated that physical, socio-economic and cultural constraints, as well as health system failures, led to fistula, and the condition imposed harsh consequences on women's lives. Constraints included deficient maternal health services and personnel, delays in seeking and accessing care, and limited fistula repair services. Women endured severe social stigma and severe economic hardships.
Conclusions
Participants' testimonies expand current understanding of women's experience of fistula and point to recommendations that could improve maternal health care, reduce women's risk of fistula, and improve the lives of women living with the condition.
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Acknowledgements
We thank all study participants, particularly the women with fistula who courageously shared their experiences of a highly stigmatizing condition. We also thank our many partners who assisted in carrying out this research: in Tanzania, Mary Zebron and Donko Francis Diu, Mary Rungwa and Maggreth Shaka from HAPA; Marrietta Mtumbuka and Barnabas Chipeta from Peramiho Mission Hospital; Yusta Ntibashima and Barnabas Solo from Kivulini; Alfreda Kabakama and Appolonia Makubi from Bugando Medical Center; and Simon Nkanda and Emili Kirako from Women's Dignity. In Uganda, Alice Emasu and Janneth Apugo from the Terrewode; Obed Kabanda and Louise Kabugho from the Good Hope Foundation; Annet Nangonzi, Adah Nkollenta and Regis Nansubuga from Kitovu Mission Hospital. From international organizations, Karen Beattie, Rachel Goldberg and Mary Nell Wegner from EngenderHealth; Malika Gujrati, Nicole Barber, John Lindsey, and Mevi Gray from the New School for Social Research; and Jennifer Harris Requejo with the World Health Organization.
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Bangser, M., Mehta, M., Singer, J. et al. Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. Int Urogynecol J 22, 91–98 (2011). https://doi.org/10.1007/s00192-010-1236-8
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DOI: https://doi.org/10.1007/s00192-010-1236-8