Obstetric fistula in Tanzania and its linkages to social vulnerability: Results of a qualitative study


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

4266.0: Tuesday, December 13, 2005 - Board 4

Abstract #108241

Maggie Bangser, MPPM¹, Rachel Goldberg, MPH², Catherine Kamugumya, RN¹, Manisha Mehta, MIA², and Atu Mwangomale, BA¹. (1) Women's Dignity Project, PO Box 79402, Dar es Salaam, Tanzania, 255.22.2152577 / 8, mbangser@cats-net.com, (2) EngenderHealth, 440 Ninth Avenue, 13th Floor, New York, NY 10001

Purpose

The Women's Dignity Project, EngenderHealth and Tanzanian partners implemented a qualitative study to examine the multiple dimensions of obstetric fistula, identify local solutions to the problem, and develop tools to prevent and manage fistula.

Methods

Data was collected in three districts of Tanzania using different qualitative methods including in-depth interviews and focus groups. Participants included women with fistula, their families, community members and health workers. Free fistula treatment was provided to all women with fistula identified during the study. Thematic analysis of the data was performed using Atlas-Ti. Findings were shared with participants, communities, and district officials, and their feedback fed into analysis, recommendations, and tool development.

Findings

Some examples of key findings are: · While the vast majority of women had made multiple ANC visits, the care they received was insufficient. · The most common delays in receiving emergency obstetric care were recognition of the problem and transportation to a facility. · The vast majority of women with fistula maintained good relationships with their families including husbands if they were married. · Nearly all of the women with fistula withdrew from religious and social events, though many said this was because of shame about their condition rather than external stigma. · Fistula had large economic ramifications for families. Families faced numerous costs for treatment; the woman with fistula often could no longer earn income; and members needed to take time away from work to care for the women.

Recommendations

Based on the findings and recommendations of participants and communities, the researchers will develop a set of “tools” that will better enable families, communities and health workers to prepare for safe delivery; facilitate the care, treatment, and community reintegration of women who experience fistula; and improve the quality of ANC, fistula repair, and emergency obstetric care services.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to

1. Articulate the multiple dimensions of obstetric fistula (causes, impact, linkages to social vulnerability).
2. Recognize that obstetric fistula is a public health problem rooted in socio-economic and structural causes, and that solutions must address the community, health systems, and policy levels.
3. Assess the benefits of participatory, community-based research in designing locally appropriate programs particularly in reference to a highly stigmatizing condition.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Taking Care of Mothers

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA