Are some women more at risk of obstetric fistula in Uganda? Evidence from the Uganda Demographic and Health Survey.

With only four years left for the Millennium Development Goal's 2015 deadline for reducing poor maternal health outcomes, developing countries are still bearing a huge burden of maternal morbidity worldwide. Estimates show that over 2 million women worldwide are suffering from obstetric fistula, the majority of which live in sub-Saharan Africa, Southeast Asia, and the Arab region. The purpose of this study is to shed a light on obstetric fistula by examining risk factors associated with this morbidity in Uganda. Descriptive and multivariate analyses were conducted using data from the 2006 Uganda Demographic and Health Survey. Older age at first sexual intercourse was significantly associated with a lower risk of obstetric fistula (OR=0.302) compared to younger age at first intercourse (7-14 years). Lack of autonomy was negatively associated with the risk of obstetric fistula; women who have problems securing permission from their husband to go seek care (OR=1.658) were more likely to suffer from this morbidity. Significant differentials in obstetric fistula have also been observed based on the region of residence: women living in Central (OR=4.923), East Central (OR=3.603), West Nile (OR=2.049), and Southwest (1.846) more likely to suffer from obstetric fistula than women living in North Central. Findings demonstrate the importance of improving geographical accessibility to maternal health care services, and emphasize the need to reinforce intervention programs, which seek to address gender inequalities.