Donnelly Kyla, Oliveras Elizabeth, Tilahun Yewondwossen, Belachew Mehari, Asnake Mengistu
a The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College , Lebanon , NH , USA.
Cult Health Sex. 2015;17(2):150-64. doi: 10.1080/13691058.2014.964320. Epub 2014 Oct 15.
Despite growing recognition of the importance of linking obstetric fistula prevention and treatment strategies with rehabilitation and social reintegration programmes, little research and programming has been oriented toward this goal. Using in-depth interviews, this study aimed to examine the experiences of 51 Ethiopian women after fistula repair surgery to identify priority post-repair interventions that could maximise their quality of life. The results showed that the majority of women felt a dramatic sensation of relief and happiness following repair, yet some continued to experience mental anguish, stigma, and physical problems regardless of the outcome of the procedure. All women suffered intense fear of developing another fistula, most commonly from sex or childbirth. Despite this, the majority of women had sex or planned to do so, while a smaller cohort avoided intercourse and childbearing, thus subjecting them to isolation, marital conflict, and/or economic vulnerability. Our findings suggest that obstetric fistula programmes should integrate (1) post-repair counselling about fistula and risk factors for recurrence, (2) community-based follow-up care, (3) linkages to income-generating opportunities, (4) engagement of women affected by fistula for community outreach, and (5) metrics for evaluating rehabilitation and social reintegration efforts to ensure women regain healthy, productive lives.
尽管人们越来越认识到将产科瘘预防和治疗策略与康复及社会重新融入计划联系起来的重要性，但针对这一目标的研究和项目却很少。本研究通过深入访谈，旨在调查51名埃塞俄比亚妇女在瘘管修复手术后的经历，以确定能最大限度提高其生活质量的修复后优先干预措施。结果显示，大多数妇女在修复后感到如释重负和幸福，但仍有一些妇女无论手术结果如何，继续经历精神痛苦、耻辱感和身体问题。所有妇女都极度担心再次患上瘘管，最常见的原因是性行为或分娩。尽管如此，大多数妇女有过性行为或计划进行性行为，而一小部分人避免性交和生育，从而使她们面临孤立、婚姻冲突和/或经济脆弱性。我们的研究结果表明，产科瘘项目应整合以下内容：（1）关于瘘管和复发风险因素的修复后咨询；（2）基于社区的后续护理；（3）与创收机会的联系；（4）让受瘘管影响的妇女参与社区宣传；（5）评估康复和社会重新融入努力的指标，以确保妇女重新过上健康、有成效的生活。
