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Tweneboah R, Budu E, Asiam PD, Aguadze S, Acheampong F. Awareness of obstetric fistula and its associated factors among reproductive-aged women: Demographic and health survey data from Gambia. PLoS One 2023; 18:e0283666. [PMID: 37023216 PMCID: PMC10079005 DOI: 10.1371/journal.pone.0283666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
Childbirth complications continue to remain a major problem in various settings but most rampant in underdeveloped nations, including Gambia, where poor living condition is widespread. Obstetric Fistula (OF) has been cited as one of the most common issues experienced by mothers during labor over the years. The study thus focuses on evaluating the level of awareness of this condition among Gambian women of childbearing age. Women's Data from the recent Demographic and Health Survey (DHS) in Gambia was used for the study. A total of 11,864 women of reproductive age, who had completed cases of the variables of interest were used for the analysis. Stata version-16 was used in carrying out the analysis of this study; and Pearson Chi-square test for independence was used to examine the distribution of the awareness of fistula among Gambian women across the explanatory variables. A two model binary logistic regression was fitted to examine the association between the outcome variable and the explanatory variables. The study presented that, majority of the Gambian women (87.2%) had no knowledge about Obstetric Fistula, as they indicated to have never heard of the condition. Considering the individual factors, age was seen to be a significant factor in determining the awareness level of Obstetric Fistula among women of childbearing age. As they age, the higher their odds of knowing about the condition. Other factors such as level of education, marital status, pregnancy termination, media exposure, community poverty level, and employment were also discovered to be significant factors in determining a woman's awareness of Obstetric Fistula. Considering the low level of awareness of Obstetric Fistula among Gambian women, there is therefore the need for the appropriate institutions to increase health educational programmes targeted at creating its awareness, and to provide further in-depth understanding of the condition to the few who already have a fair knowledge about it.
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Affiliation(s)
- Rabbi Tweneboah
- Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eugene Budu
- Research Unit, Korle Bu Teaching Hospital, Accra, Ghana
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Boene H, Mocumbi S, Högberg U, Hanson C, Valá A, Bergström A, Sevene E, Munguambe K. Obstetric fistula in southern Mozambique: a qualitative study on women's experiences of care pregnancy, delivery and post-partum. Reprod Health 2020; 17:21. [PMID: 32005268 PMCID: PMC6995132 DOI: 10.1186/s12978-020-0860-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obstetric fistula is still common in low- and middle-income countries (LMIC) despite the on-going shift to increased facility deliveries in the same settings. The social behavioural circumstances in which fistula, as well as its consequences, still occur are poorly documented, particularly from the perspective of the experiences of women with obstetric fistula. This study sought to describe women's experiences of antenatal, partum and post-partum care in southern Mozambique, and to pinpoint those experiences that are unique to women with fistula in order to understand the care-seeking and care provision circumstances which could have been modified to avoid or mitigate the onset or consequences of fistula. METHODS This study took place in Maputo and Gaza provinces, southern Mozambique, in 2016-2017. Qualitative data were collected through in-depth interviews conducted with 14 women with positive diagnoses of fistula and an equal number of women without fistula. All interviews were audio-recorded and transcribed verbatim prior to thematic analysis using NVivo11. RESULTS Study participants had all attended antenatal care (ANC) visits and had prepared for a facility birth. Prolonged or obstructed labour, multiple referrals, and delays in receiving secondary and tertiary health care were common among the discourses of women with fistula. The term "fistula" was rarely known among participants, but the condition (referred to as "loss of water" or "illness of spillage") was recognised after being prompted on its signs and symptoms. Women with fistula were invariably aware of the links between fistula and poor birth assistance, in contrast with those without fistula, who blamed the condition on women's physiological and behavioural characteristics. CONCLUSION Although women do seek antenatal and peri-partum care in health facilities, deficiencies and delays in birth assistance, referral and life-saving interventions were commonly reported by women with fistula. Furthermore, weaknesses in quality of care, not only in relation to prevention, but also the resolution of the damage, were evident. Quality improvement of birth care is necessary, both at primary and referral level. There is a need to increase awareness and develop guidelines for prevention, early detection and management of obstetric fistula, including early postpartum treatment, availability of fistula repair for complex cases, and rehabilitation, coupled with the promotion of community consciousness of the problem.
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Affiliation(s)
- Helena Boene
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Vila da Manhiça, 1121, Manhiça, Mozambique
| | - Sibone Mocumbi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Av. Agostinho Neto 679, 1100, Maputo, Mozambique. .,Department of Women's and Children's Health, Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.
| | - Ulf Högberg
- Department of Women's and Children's Health, Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden
| | - Claudia Hanson
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavagen 18A, Plan 4, Stockholm, Sweden.,Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Anifa Valá
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Vila da Manhiça, 1121, Manhiça, Mozambique
| | - Anna Bergström
- Department of Women's and Children's Health, Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.,University College London, Institute for Global Health, Gower St, London, WC1E 6BT, UK
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Vila da Manhiça, 1121, Manhiça, Mozambique.,Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, UEM, Av. Salvador Allende 702 R/C, Maputo, Mozambique
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Vila da Manhiça, 1121, Manhiça, Mozambique.,Department of Community Health, Faculty of Medicine, UEM, Av. Salvador Allende 702 R/C, Maputo, Mozambique
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Mocumbi S, Högberg U, Lampa E, Sacoor C, Valá A, Bergström A, von Dadelszen P, Munguambe K, Hanson C, Sevene E. Mothers' satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique. BMC Pregnancy Childbirth 2019; 19:303. [PMID: 31426758 PMCID: PMC6701029 DOI: 10.1186/s12884-019-2449-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Background Client satisfaction is an essential component of quality of care. Health system factors, processes of care as well as mothers’ characteristics influence the extent to which care meets the expectations of mothers and families. In our study, we specifically aimed to address the mothers’ experiences of, and satisfaction with, care during childbirth. Methods A population-based cross-sectional study, using structured interviews with published sequences of questions assessing satisfaction, including 4358 mothers who gave birth during the 12 months before June 2016 to estimate satisfaction with childbirth care. Regression analysis was used to determine the predictors of client satisfaction. Results Most mothers (92.5%) reported being satisfied with care during childbirth and would recommend that a family member to deliver at the same facility. Specifically, 94.7% were satisfied with the cleanliness of the facility, 92.0% reported being satisfied with the interaction with the healthcare providers, but only 49.8% felt satisfied with the assistance to feed their baby. Mothers who had negative experiences during the process of care, such as being abandoned when needing help, disrespect, humiliation, or physical abuse, reported low levels of satisfaction when compared to those who had not had such experiences (68.5% vs 93.5%). Additionally, they reported higher levels of dissatisfaction (20.1% vs 2.1%). Regression analysis revealed that mothers who gave birth in primary level facilities tended to be more satisfied than those who gave birth in hospitals, and having a companion increased, on average, the overall satisfaction score, with 0.06 in type II health centres (CI 0.03–0.10) and with 0.05 in type I health centres (CI − 0.02 – 0.13), compared to − 0.01(CI -0.08 – 0.07) in the hospitals, irrespective of age, education and socio-economic background. Conclusion Childbirth at the primary level facilities contributes to the level of satisfaction. The provision of childbirth care should consider women’s preferences and needs, including having a companion of choice. We highlight the challenge in balancing safety of care versus satisfaction with care and in developing policies on the optimum configuration of childbirth care. Interventions to improve the interaction with providers and the provision of respectful care are recommended. Electronic supplementary material The online version of this article (10.1186/s12884-019-2449-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sibone Mocumbi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Av. Salvador Allende 702, 1100, Maputo, Mozambique. .,Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Centre, Uppsala University, Dag Hammarskjölds väg 38, 751 85, Uppsala, Sweden
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique
| | - Anifa Valá
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique
| | - Anna Bergström
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.,University College London, Institute for Global Health, Gower St, London, WC1E 6BT, UK
| | - Peter von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, 1 Lambeth Palace Road, London, SE1 7EU, UK
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique.,Department of Public Health, Faculty of Medicine, Universidade Eduardo Mondlane, Av. Salvador Allende 702 R/C, Maputo, Mozambique
| | - Claudia Hanson
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavagen 18A, Plan 4, Stockholm, Sweden.,Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique.,Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Universidade Eduardo Mondlane, Av. Salvador Allende 702 R/C, Maputo, Mozambique
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