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Psychosocial impact of obstetric fistula in women presenting for surgical care in Tanzania

Siddle, Kathryn L., Mwambingu, Subila, Malinga, Theodora and Fiander, Alison Nina 2013. Psychosocial impact of obstetric fistula in women presenting for surgical care in Tanzania. International Urogynecology Journal 24 (7) , pp. 1215-1220. 10.1007/s00192-012-1994-6

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Introduction and hypothesis: World Health Organisation data suggest that two million women live with the physical and psychosocial effects of obstetric fistula. As part of an expanded fistula programme in Tanzania, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) introduced an evaluation strategy to include impact of surgery on psychosocial aspects of obstetric fistula. This is an initial report documenting morbidity on admission. Methods: A questionnaire assessing the impact of obstetric fistula was developed taking into account literature in the field including sections on: patient contact information, transport costs and a set of statements regarding the effects of fistula. The effects were spread across five domains: the physical consequences of obstetric fistula, the effects of a difficult delivery and possible stillbirth, the experience of isolation, the inability to undertake daily living activities and feelings of depression. The questionnaire was administered in Kiswahili by Tanzanian counsellors shortly after admission of patients onto the fistula ward. Results: A total of 100 fistula patients reported high rates of physical and psychosocial morbidity. Over half of the patients said they would not have been able to access treatment without the transport costs being covered. Conclusions: Fistula patients are affected by extremely high rates of physical and psychosocial morbidity. Further work is required to confirm these findings, validate assessment tools and assess contributing factors in greater detail over time, such as the effect of stillbirth, as well as the impact of surgery.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Postgraduate Medical and Dental Education
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RD Surgery
R Medicine > RG Gynecology and obstetrics
Uncontrolled Keywords: Depression; Fistula; Obstetric fistula; Psychosocial effects; Stillbirth; Vesico-vaginal fistula
Publisher: Springer
ISSN: 0937-3462
Last Modified: 15 Feb 2020 15:38

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