Psychosocial Burden of Obstetric Fistula Among Women in South-South Nigeria

PSYCHOSOCIAL BURDEN OF OBSTETRIC FISTULA

Abstract

Background: Obstetric fistula, a medical and psychosocial problem, is a source of misery for women in low- and middle-income countries. This study was aimed at identifying the psychosocial impact of obstetric fistula among women in Cross River State of Nigeria.

Methodology: It was a descriptive cross-sectional study carried out among women seeking treatment for obstetric fistula in 3 hospitals in Cross River State, Nigeria. A combined purposive, proportionate and consecutive sampling technique was used to select 210 participants. Ethical approval was obtained. An interviewer-administered questionnaire was used to obtain information on the demographics, obstetric characteristics and psychosexual problems experienced by the women. Data was analyzed with SPSS version 20. Chi-square was used to compare categorical variables. A P-value of less than 0.05 was considered significant.

Results: The mean age of the women was 33.7+16.6 years. The commonest psychosocial problem encountered by the participants was depression which was experienced by 175 (83.3%) women. Other problems included social discrimination in 151 (71.9%) women, sleep disturbance in 143 women (68.1%), loss of libido in 138 women (65.7%), loss of job/means of livelihood in 86 women (41.0%), extreme poverty (34.3%), ostracism in 54 women (25.4%) and divorce/marital separation in 27 women (12.9%).

Conclusion: Obstetric fistula has enormous psychosocial burden on the women affected, the commonest problem being depression. Beyond urinary continence, the goals of treatment should include social rehabilitation, re-integration, psychotherapy and mental well-being. A collaborative approach is recommended to achieve these.