Living with Obstetric Fistula: Perceived Causes, Challenges and Coping Strategies among Women Attending the Fistula Clinic at Mulago Hospital, Uganda

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.