Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
The Centre Evidence Informed Nursing, Midwifery and Health Care Practice; 270 Joondalup Drive, Joondalup, WA: A JBI Affiliated Group, Joondalup, Australia.
BMC Pregnancy Childbirth. 2022 Sep 3;22(1):680. doi: 10.1186/s12884-022-05013-2.
Obstetric fistula used as synonymous with VVF in this study, is an abnormal communication/hole between the urinary tract and the genital tract or the gastrointestinal tract and the genital tract, resulting from prolonged obstructed labour. VVF may cause sufferers to experience chronic urinary/faecal incontinence, and the stigma of continuing foul odour. VVF is primarily caused by prolonged obstructed labour, which is brought about by a range of causes. Recently, it has been proposed that women's groups and fistula survivors should suggest interventions to reduce or prevent the incidence of obstetric fistula.
The objective of this review was to synthesise what is reported about women's views and experiences of the risk factors underlying the causes of VVF.
A systematic approach outlined in the Joanna Briggs Institute Manual for Evidence synthesis was followed for this review, articles published since the last 11 years from 2011 to 2021 were selected against several criteria and critically appraised using JBI Critical Appraisal Checklist for qualitative studies.
Nine studies were retained for inclusion in this review and the data were then synthesised into five themes: (1) Cultural beliefs and practices impeding safe childbirth, (2) Lack of woman's autonomy in choices of place to birth safely, (3) Lack of accessibility and social support to safe childbirth, (4) Inexperienced birth attendants and, (5) Delayed emergency maternal care (childbirth).
This review highlights the complexity of risk factors predisposing women to the known causes of VVF. It also illuminates the absence of women's voices in the identification of solutions to these risks. Women are most directly affected by VVF. Therefore, their knowledge, views, and experiences should be considered in the development and implementation of strategies to address the issue. Exploring women's views on this issue would enable the identification of gaps in maternity care provision, which would be of interest to community and health service leaders as well as policymakers in Sub-Saharan Africa.
本研究中将产科瘘管用作尿瘘（VF）的同义词，是指由于产程延长导致的泌尿道和生殖道之间或胃肠道和生殖道之间的异常沟通/孔道。VF 可导致患者出现慢性尿/粪失禁，并伴有持续恶臭的耻辱感。VF 主要由产程延长引起，而这又由一系列原因导致。最近，有人提出妇女团体和瘘管幸存者应提出干预措施，以减少或预防产科瘘管的发生。
本综述旨在综合报告有关女性对导致 VF 发生的原因的风险因素的看法和经验。
本综述采用了乔安娜·布里格斯研究所证据综合手册中概述的系统方法，根据若干标准选择了自 2011 年至 2021 年发表的文章，并使用 JBI 定性研究批判性评估清单对其进行了批判性评估。
本综述纳入了 9 项研究，然后将数据综合成五个主题：（1）阻碍安全分娩的文化信仰和习俗；（2）妇女在选择安全分娩地点方面缺乏自主权；（3）缺乏获得安全分娩的机会和社会支持；（4）缺乏经验的分娩人员；（5）产妇急救护理延迟。
本综述强调了导致妇女面临已知 VF 风险因素的复杂性。它还阐明了在确定这些风险的解决方案时，缺乏女性的声音。女性是 VF 最直接的受害者。因此，在制定和实施解决这一问题的策略时，应考虑到她们的知识、观点和经验。探讨女性对这一问题的看法将有助于发现母婴保健服务提供方面的差距，这将引起撒哈拉以南非洲社区和卫生服务领导者以及政策制定者的兴趣。
