Mohamed Adam A, Ilesanmi Abiodun O, Dairo M David
Pan African University Life and Earth Sciences Institute (PAULESI), University of Ibadan, Ibadan, Nigeria.
Department of Public Health, Faculty of Health Sciences, Global Science University, Galkayo, Somalia.
Obstet Gynecol Int. 2018 Sep 27;2018:5250843. doi: 10.1155/2018/5250843. eCollection 2018.
Obstetric fistula is a severe maternal morbidity which can have devastating consequences for a woman's life and is generally associated with poor obstetric services leading to prolonged obstructed labour. The predisposing factors and consequences of obstetric fistula differ from country to country and from community to community. The World Health Organization estimated that more than 2 million women in sub-Saharan Africa, Asia, the Arab region, Latin America, and the Caribbean are living with the fistula, and some 50,000 to 100,000 new cases develop annually with 30,000-90,000 new cases developing each year in Africa alone. This study aimed at describing and exploring the experiences of women living with obstetric fistulas following corrective surgery in Benadir and Mudug regions, Somalia. Women living with obstetric fistula who had surgical repairs at Daynile and GMC fistula centers and key informants were identified purposively. Twenty-one individual in-depth interviews among women with obstetric fistula and eight key informant interviews were conducted. Thematic analyses were used. Codes were identified, and those codes with similar connections were organized together as to form themes. Detailed reading and rereading of the transcribed interviews were employed in order to achieve and identify themes and categories. Themes, categories, and subcategories illustrating the experiences of women living with obstetric fistula emerged from the thematic analysis of individual in-depth and key informant interviews. These were challenges of living with OBF which include "wounds around genitalia, bad odour, incontinences of urine and feces, stigma, isolation, divorce, powerlessness, dependency, financial constraints, and loss of healthy years" and coping mechanisms which include "withdrawal from the community and improved personal hygiene." Women with obstetric fistula experience serious health and social consequences which prevents them fulfill social, family, and personal responsibilities. We recommend expansion of BEmONC services to underserved areas, capacity building for local OBF surgeons, and improved media campaign and birth preparedness at community levels.
产科瘘是一种严重的孕产妇疾病，会给女性的生活带来毁灭性后果，通常与产科服务不佳导致产程延长受阻有关。产科瘘的诱发因素和后果因国家和社区而异。世界卫生组织估计，撒哈拉以南非洲、亚洲、阿拉伯地区、拉丁美洲和加勒比地区有超过200万妇女患有瘘管病，每年约有5万至10万新病例出现，仅非洲每年就有3万至9万新病例。本研究旨在描述和探索索马里贝纳迪尔和穆杜格地区接受矫正手术后患有产科瘘的妇女的经历。有目的地确定了在代尼尔和GMC瘘管中心接受手术修复的患有产科瘘的妇女以及关键信息提供者。对21名患有产科瘘的妇女进行了个人深度访谈，并对8名关键信息提供者进行了访谈。采用了主题分析法。确定了代码，并将那些具有相似联系的代码组织在一起形成主题。为了达成并确定主题和类别，对转录的访谈进行了详细阅读和反复阅读。对个人深度访谈和关键信息提供者访谈的主题分析得出了说明患有产科瘘的妇女经历的主题、类别和子类别。这些包括患有产科瘘生活的挑战，即“生殖器周围伤口、异味、大小便失禁、耻辱、孤立、离婚、无力、依赖、经济困难和失去健康岁月”，以及应对机制，即“退出社区和改善个人卫生”。患有产科瘘的妇女经历着严重的健康和社会后果，这使她们无法履行社会、家庭和个人责任。我们建议将基本产科急诊护理服务扩展到服务不足的地区，为当地产科瘘外科医生进行能力建设，并在社区层面加强媒体宣传和分娩准备工作。
