Determination of origin of obstetric fistula in patients who seek treatment in Ebonyi, Nigeria

The purpose of this investigation was to determine the origin of obstetric fistula (OF) patients in the Ebonyi state of Nigeria. Nigeria is often associated with a high burden of OF, but the extent of the burden throughout the country is unknown, particularly because studies have primarily focused on the northern, Muslim part of the country, where religious/cultural practices are thought to be a root cause of the condition. In an effort to respond to the lack of research in southern Nigeria, we worked with the South East Regional Fistula Centre (SERFC), part of the Ebonyi State Teaching Hospital in Abakaliki, Ebonyi. During six weeks in April and May 2009, locational and demographic data was collected from SERFC hospital records in order to identify the origin of patients within Ebonyi state. De-identified patient addresses were mapped at the local government area (LGA), development centre (DC), and community levels. A detailed questionnaire was also completed for each patient and merged with a database of previous patients. The data showed a wide distribution of OF patients within the state, as well as a small number of patients seeking care from the neighboring state of Cross River. The widespread distribution of OF patients in the region indicates that there is a need for social rehabilitation and repair services, and future programs should focus on these issues.