Dissertation (MSc Midwifery)
Obstetric fistula (OF) is a public health challenge that is among the previously neglected components of maternal health in the developing world. The condition, which in the recent past has increasingly drawn more attention from the public, has a devastating impact on the health and wellbeing of both women and girls worldwide. The most common cause of obstetric fistula in developing countries is prolonged obstructed labor. The problem affects approximately2 million women and girls across Africa and Asia. The objective of this study was to assess the psychosocial and economic impacts and the coping mechanisms among fistula survivors who were admitted at Bugando Referral Hospital in Mwanza, Tanzania. A study employed qualitative research approach with phenomenological research design. In-depth interviews and a question guide were used to collect data from women aged 19–55 years who had sustained obstetric fistula. Documentary review was also employed in order to obtain more additional information of the participants. Data was analyzed using thematic and content analysis. A total number of 13 women with Obstetric Fistula were involved in the study. The study findings showed that 77% experienced stigma from the community, 55.7% of the women got separated and 15% divorced from their marital partners after sustaining Obstetric Fistula. In general, the findings revealed that fistula survivors continued to suffer from shame, rejection, isolation and stigma. Economically most women resulted in being dependant as a result of Obstetric Fistula. Some of the reintegration or coping strategies for fistula survivors included vi seeking for successful repair, restricting from social activities, relocation from their original home to new environments and setting the husband free to marry another wife. The study concluded that, women with Obstetric Fistula suffered from psychosocial and economic hardships. Yet they applied various strategies, some of them torturing, in trying to cope with the situation. Mass education is required, for minimizing stigma and discrimination towards obstetric fistula, and changing attitudes for women to seek early medical care at nearby health facilities during pregnancy and labor. Other efforts should be strengthening the health system, and enacting a comprehensive and holistic fistula care approach to facilitate the reintegration process and restoration of women dignity.