The effects of obstetric fistula, impact and coping strategies of women in Kaptembwa – Nakuru, Kenya

Abstract

Obstetric fistula is complication of pregnancy that affects women following prolonged obstructed labor. Most instructive in this respect, is the continuous leakage of urine as well as the far reaching effects on, physical, emotional, economic and social suffering associated with it, which has a profound impact on women and men’s livelihoods. Therefore it was found imperative to evaluate the causes of obstetric fistula on affected women of Kaptembwa Nakuru, and appraise the impact on the well-being of women and how their experiences have shaped their identities and families. The study was conducted with qualitative and quantitative components to explore the causes, experiences and impact of obstetric fistula. Social, Psycho-Social, Medical and Demographic traditional theories were used to investigate and evaluate the root cause of the social problem that has affected women and their families, assisting in exploring the impact and coping strategies, hence explaining the relationship of the variables and other factors that moderate the same. The sample population was 74 confidently selected samples and 10 interviewed during pilot testing, inclusive of key informants and case studies of 3 women (depth interviews) as the rest of the women responded to the questionnaires. Focus group discussion was done with husbands who have experienced effects of obstetric fistula. The interview schedules and questionnaires were used in collection of data. Data was analyzed using content data analysis framework and Statistical package for the Social Science. (SPSS). Obstetric fistula prevails amongst women aged between 25 -39 years. The difficulty of assessing the exact numbers of women affected with obstetric fistula was attributed to it being an embarrassing and humiliating medical condition, leading to isolation. The foul odor emanating from affected women leads to humiliation; sever social-cultural stigmatization and thus, inability to perform their gender roles. Hindrance from participating in gainful income activities has led them into despair and begging. In order to combat this debilitating disease, community education that informs on the potential risks of obstetric fistula particularly amongst people residing in rural and informal settlements areas is a must. Essential information includes danger signs during delivery and rapid access to caesarean section delivery for cases of obstructed delivery. Access to affordable fistula repair must also be provided in the County Health facilities. The findings of this study may assist these women to seek better ways and means to address their problems. The knowledge will help them improve their self worth and maintain their identity as women, wives, friends, and community members. The findings will also assist medical practitioners and community in making recommendation to policy makers, implementers, and relevant stakeholders in strategizing, planning and implementing appropriate ways to address the problem.