Budu Eugene, Ahinkorah Bright Opoku, Okyere Joshua, Seidu Abdul-Aziz, Aboagye Richard Gyan, Yaya Sanni
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Trop Med Health. 2022 Aug 2;50(1):50. doi: 10.1186/s41182-022-00443-2.
Awareness about obstetric fistula and its concomitant factors is central to efforts to eliminate obstetric fistula in sub-Saharan Africa. We, therefore, assessed the magnitude of obstetric fistula awareness and its associated factors among women of reproductive age in sub-Saharan Africa.
Data for the study were extracted from the most recent Demographic and Health Surveys of 14 countries in sub-Saharan Africa. We included 185,388 women aged 15-49 years in this study. Percentages were used to summarise the prevalence of obstetric fistula awareness across the 14 countries studied. We adopted a multivariable multilevel binary logistic regression to examine the factors associated with obstetric fistula awareness in sub-Saharan Africa. We presented the results of the regression analysis using adjusted odds ratios with their 95% confidence intervals. Statistical significance was set at p < 0.05.
The average prevalence of obstetric fistula awareness was 37.9%, ranging from 12.8% in Gambia to 63.9% in Uganda. Awareness of obstetric fistula was low among never married and cohabiting women compared to married women. Compared with women with parity 4 or more, those with no birth had the lowest odds of obstetric fistula awareness. The study also showed that obstetric fistula awareness was lower among women who were working, those who are not exposed to mass media, those in the poorest wealth category, those who have never had sex, and those in communities with low literacy level. The study however found that the odds of obstetric fistula awareness increased with age and education, and was higher in urban areas compared to rural areas. Women, who had ever terminated a pregnancy were more likely to be aware of obstetric fistula compared to those who had never terminated a pregnancy.
The study demonstrated a low awareness of obstetric fistula among women in sub-Saharan Africa. Educative and sensitisation interventions should incorporate the factors identified in the present study during its implementation. To raise women's awareness of obstetric fistula, there is the need for sub-Saharan African countries to consciously raise community literacy rate, increase access to mass media platforms and invest intensively in formal education for women.
了解产科瘘及其相关因素是撒哈拉以南非洲消除产科瘘工作的核心。因此，我们评估了撒哈拉以南非洲育龄妇女对产科瘘的知晓程度及其相关因素。
本研究数据取自撒哈拉以南非洲14个国家最近的人口与健康调查。本研究纳入了185388名年龄在15至49岁之间的女性。百分比用于总结所研究的14个国家产科瘘知晓率。我们采用多变量多层次二元逻辑回归来研究撒哈拉以南非洲与产科瘘知晓相关的因素。我们使用调整后的比值比及其95%置信区间呈现回归分析结果。统计学显著性设定为p < 0.05。
产科瘘知晓率的平均水平为37.9%，范围从冈比亚的12.8%到乌干达的63.9%。与已婚妇女相比，未婚和同居妇女对产科瘘的知晓率较低。与生育4胎及以上的妇女相比，未生育妇女知晓产科瘘的几率最低。研究还表明，在职妇女、未接触大众媒体的妇女、最贫困财富类别的妇女、从未有过性行为的妇女以及识字水平低的社区中的妇女对产科瘘的知晓率较低。然而，研究发现产科瘘知晓几率随年龄和教育程度增加，且城市地区高于农村地区。与从未终止妊娠的妇女相比，曾经终止妊娠的妇女更有可能知晓产科瘘。
该研究表明撒哈拉以南非洲妇女对产科瘘的知晓率较低。教育和宣传干预措施在实施过程中应纳入本研究确定的因素。为提高妇女对产科瘘的认识，撒哈拉以南非洲国家有必要有意识地提高社区识字率，增加大众媒体平台的接入，并大力投资于妇女的正规教育。
