Prevalence and factors related to obstetric fistula patients managed in jimma university specialized teaching hospital, south west Ethiopia

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.