Silently waiting to heal: experiences among women living with urinary incontinence in northwest Ethiopia.

INTRODUCTION AND HYPOTHESIS

The aim of this study was to gain in-depth knowledge of women suffering from urinary incontinence (UI) in rural and semiurban settings in Ethiopia.

METHODS

A qualitative study based on semistructured in-depth interviews with 26 informants, 18 of whom were women experiencing the symptom of urinary leakage. The study was conducted in the Amhara Region of northwest Ethiopia and was part of the Dabat Incontinence and Prolapse (DABINCOP) study.

RESULTS

Limited access to water, soap, pads, and spare clothes characterized daily management of the symptom. The consequences for marital relationships and social life were of great concern to the informants. Shame, embarrassment, and fear of being discriminated against led to huge efforts to hide the leakage. Among informants who were not able to hide it, humiliating comments and discriminatory behavior were commonly experienced, sometimes leading to divorce and self-isolation. Women who disclosed their symptom usually had a person who supported them. Women with UI regarded it as unnatural and uncommon. Most took no action to improve the situation, as they saw no options for help.

CONCLUSIONS

Several circumstances limited the opportunities available to women to keep themselves clean, disclose the problem to others, and access health information and health-care facilities. In order to understand how women in this setting practically handled, perceived, and experienced living with UI, it was essential to address contextualized and sociocultural dimensions related to the symptom.