Abstract
Obstetric fistula is a sequela of complicated labour, which, if untreated, leaves women handicapped and socially excluded. In Burkina Faso, incidence of obstetric fistula is 6/10,000 cases amongst gynaecological patients, with more patients affected in rural areas. This study aims to evaluate knowledge on obstetric fistula among young women in a health district of Burkina Faso, comparing rural and urban communities. This cross-sectional study employed multi-stage sampling to include 121 women aged 18-20 years residing in urban and rural communities of Boromo health district. Descriptive statistics and multiple logistic regression analysis were used to compare differences between the groups and to identify predictors of observed knowledge levels. Rural women were more likely to be married (p<0.000) and had higher propensity to teenage pregnancy (p=0.006). The survey showed overall poor obstetric fistula awareness (36%). Rural residents were less likely to have adequate preventive knowledge than urban residents [OR=0.35 (95%-CI, 0.16–0.79)]. This effect was only slightly explained by lack of education [OR=0.41 (95%-CI, 0.18–0.93)] and only slightly underestimated due to previous pregnancy [OR=0.27 (95%-CI, 0.09–0.79)]. Media were the most popular source of awareness amongst urban young women in contrast to their rural counterparts (68% vs. 23%). Most rural young women became ‘aware’ through word-of-mouth (68% vs. 14%). All participants agreed that the hospital was safer for emergency obstetric care, but only 11.0% believed they could face pregnancy complications that would require emergency treatment. There is urgent need to increase emphasis on neglected health messages such as the risks of obstetric fistula. In this respect, obstetric fistula prevention programs need to be adapted to local contexts, whether urban or rural, and multi-sectoral efforts need to be exerted to maximise use of other sectoral resources and platforms, including existing routine health services and schools, to ensure sustainability of health literacy efforts.
Highlights
Obstetric Fistula is defined as a direct communication between the vagina and the bladder and/or between the vagina and the rectum [1]
Several factors have been linked to the high occurrence of obstetric fistula in sub-Saharan Africa, including the preponderance of early marriage and teenage pregnancy, which in turn mean that the girls do not have pelvises which have sufficiently developed to allow reproduction [10]
Emergency, with no significant association with rural residency (Table 3). The results of this survey among young women in Burkina Faso suggest that the prevalence of awareness of obstetric fistula and knowledge on prevention are low in both urban and rural areas
Summary
Obstetric Fistula is defined as a direct communication between the vagina and the bladder (vesico-vaginal fistula) and/or between the vagina and the rectum (recto-vaginal fistula) [1]. Several factors have been linked to the high occurrence of obstetric fistula in sub-Saharan Africa, including the preponderance of early marriage and teenage pregnancy, which in turn mean that the girls do not have pelvises which have sufficiently developed to allow reproduction [10]. This is further compounded by the poor nutritional status of most of the girls who live in these highly deprived settings [11,12]
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