156562 Pregnancy related fistula: For women in rural Ethiopia a cause for social ostracism no less than HIV/AIDS

Tuesday, November 6, 2007

Yared Abera, MD, MPH , Pathfinder International Ethiopia, Addis Ababa, Ethiopia
Amare Yeshiambaw, BSC , Pathfinder International Ethiopia, Addis Ababa, Ethiopia
Ethiopia has one of the highest maternal mortality rates in the world. Obstetric fistula is a common, but neglected problem in rural Ethiopia, where only 12% of deliveries are assisted by trained health workers. The 2005 Demographic and Health Survey reported nearly 10,000 women with obstetric fistula (one percent of women who have ever given birth). Only 0.3% were repaired.

Pathfinder International/Ethiopia conducted a study on social repercussions for women who have suffered from obstetric fistula. Through its community health workers, Pathfinder identified and interviewed 100 mothers who were referred to a hospital for fistula repair between March and November 2006. All clients' fistulas were successfully repaired. The median age of the women was 24 years. More than 85% were illiterate. The median age at first marriage was 13 years. Seventy percent were divorced. The divorce rate increased with the length of time the fistula had been present. More than 85% were completely dependent on their families. Forty-two percent of the fistulas occurred during a woman's first birth. Fifty percent lost their child during labor. The women had lived with the problem between 3 months and 30 years (mean years 5 (SD6.5)). The average length of labor was three days without seeking medical attention. Nearly 60% never sought medical attention. Most experienced discrimination and lived as outcasts.

Learning Objectives:
1. Recognize the importance of community agents in identifying and referring women with fistula. 2. Understand the social exclusion and discrimination women with unrepaired fistula experience and the women's right to have fistula repaired.

Keywords: Reproductive Health, Women's 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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