156411 Counseling Obstetric Fistula Patients in Eritrea

Tuesday, November 6, 2007

Khaliah Johnson, BS , Stanford University, Stanford, CA
Janet Turan, PhD, MPH , Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
Letu Hailemariam, BA , Eritrea Ministry of Health, Asmara, Eritrea
Ghirmatsion G. Mahary , Eritrea Ministry of Health, Asmara, Eritrea
Mary Lake Polan, MD, PhD, MPH , Department of Gynecology and Obstetrics, Stanford University, Stanford, CA
Obstetric fistula is a devastating problem impacting the health and psychosocial well-being of affected women and their families. In Eritrea, efforts are being made to meet the complex needs of women who develop fistulas. Based on in-depth interviews conducted with fistula repair clients, a counseling program for such clients was adapted for the Eritrean context. the aims of the program were: (1) to provide information about fistula, fistula prevention, and surgical repair, (2) to improve women's self esteem, (3) to help women to explore ways to re-integrate into their communities following surgical repair, and (4) to encourage dicussion of fistula and fistula prevention with community members. Forty-seven women were counseled before and after their surgical repairs. To evaluate the intervention, clients were interviewed twice: once before pre-operative counseling and again after post-operative counseling. A questionnaire was used to assess women's knowledge about fistula, self-esteem, and behavioral intentions for post-surgery health maintenance and social re-integration. After counseling, program participants showed statistically significant improvements in their knowledge about fistula, self-esteem, and intentions to educate others about fistula. In addition, there was a statistically significant improvement in women's desire to engage in behaviors beneficial to their health, such as the use of family planning. This project represents the first formal implementation and evaluation of a counseling program for fistula patients in sub-Sharan Africa, and will likely serve as a model for other countries. In addition, such efforts to prevent and treat fistula can serve as a focal point to generate support for safe motherhood policies and programs.

Learning Objectives:
By the end of this presentation, participants will: (1) have a broad understanding of obstetric fistula as a maternal health problem (2) be able to identify the needs of fistula repair patients in Eritrea (3) be able to describe the potential benefits of pre-operative and post-operative counseling for fistula patients.

Keywords: Counseling, Maternal Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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