Abstract:
Background
Despite the increased attention on maternal mortality during recent decades,
which has resulted in maternal health being defined as millennium development
goal (MDG-5), the disability and suffering from obstetric fistula remains neglected
issue in global health. It is a continuous leakage of urine or feces or both, and
associated physical, emotional social suffering and has profound impact on women
quality of life.
Objectives
To determine prevalence and factors related to obstetric fistula patients managed
in JUSTH during the study period.
Method
A cross sectional study was carried-out on all fistula patients managed in JUSTH
between 2011 and 2014.
Data was collected from gynecology ward records office on prevalence causes and
factors through chart review, using structured questionnaire. SPSS-version 20 was
used for data analysis. Descriptive statistics was used to describe the main features
of the data. Bivariate analysis was done to determine association between
independent variables and outcome variable. Multivariate Logistic regression was
used to control the effect of confounding variables.
Result
During 2011-2014 totals of 6866 patients were admitted to gynecology ward.
Among these 216 patients were Obstetric making the prevalence of obstetric fistula
3.14%. The mean age of patients were 28.13 (SD±7.5), majority 96(44.4%) were
between the age group of 15-25 years old and 183 (84.7%) were rural residents. In
our study 100% of obstetric fistula patients were found to have prolonged labor.
The majority of obstetric fistula were caused by obstructed labor 196(90.7%) and
the probability of developing obstructed labor among patients who had been
laboring for two days was 6.20 times more likely than among patients who had
been in labor for one day (AOR=6.20, 95% CI ((1.07-36.01)), P-value = 0.042).
Conclusions = rural residency, lack of ANC follow up, prolonged labor are the
major associated risk factors. And there is slight etiologic shift in our study. But it
showed us the three delays are still persisting. Obstetric fistula is a major public
and reproductive health concern. This calls for increased access to emergency
obstetric care training of health professionals.
