Reintegration to Family and Community after Obstetric Fistula Surgery: Experiences of Ugandan Women
Collaborators from the Makerere University School of Medicine and the University of California, San Francisco conducted 16 key informant interviews and 4 focus group discussions over the period June – July 2014 with women who had obstetric fistula surgery at Mulago Hospital in the previous 6 – 24 months. Questions focused on the effect of obstetric fistula on women’s daily lives, including their mental and physical health, and post-surgical emotional, physical, social and financial experiences. Data was analyzed using deductive and inductive coding, using Atlas.ti.
Women reported a variety of physical and emotional stresses due to developing obstetric fistula including pain and weakness, depression, social isolation, and internal and external stigma. Symptoms and hygiene needs drastically reduced women’s activities, capabilities and autonomy. Many participants reported receiving emotional and tangible support from husbands and family members, and encouragement from women with fistula at the surgical camp. Perceptions of recovery focused on continence. Residual symptoms prohibited resumption of previous activities after surgery for some women. Respondents indicated the need for instrumental support for surgery and attaining economic productivity after surgery.
Achievement of continence is key for women with fistula. Counseling, health education, physical and occupational therapy, and economic assistance will likely contribute to substantial improvements in quality of life. As fistula-repair services expand, it is essential to develop and provide programming to enhance women’s post-repair family and community reintegration.
Learning Areas:Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Describe the supports and challenges to reintegration among Ugandan women who had obstetric fistula surgery. Discuss the landscape of post-surgical reintegration services broadly available to women with obstetric fistula.
Keyword(s): International MCH
Qualified on the content I am responsible for because: I am an experienced MCH epidemiologist focused on international MCH and led the conceptualization, implementation, and analysis of the project that is being presented.
Any relevant financial relationships? No
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.