Abstract
The physical and psychosocial problems associated with obstetric fistula affect the patients’ efficacy to function within specific realms of life and affect their quality of life. This study documented the obstetric fistula patients’ self-efficacy for reacceptance in the communities in Africa. The study used keywords and the year of publication (2000 to 2019) as a search strategy to obtain data for review. A Critical Appraisal Skills Programme checklist specifically for qualitative studies was used. The search resulted in 284 studies: Google Scholar; 37, PubMed; 12, Hinari; 3, African Journals Online; 36, Psych-INFO; 1 and other websites; 195. Subsequently, 258 studies were excluded due to duplication and failure to meet the study objective leaving 26 studies, which were thematically analyzed. Studies report loss of hope, dignity, confidence, and self-esteem among obstetric fistula patients. They feel unfit, and are often anxious, attributes that impede their employability, mobility, connections, conjugal affairs, childbearing, and enthusiasm to accomplish various tasks; an index of low self-efficacy. However, when repaired and empowered through skills training and counseling, their self-efficacy improves. Self-efficacy is generally low among obstetric fistula patients especially those that have not yet had fistula repair. Alongside repair of the fistula, activities intended for societal reintegration reduce levels of anxiety, increase confidence and overall self-efficacy, which enables reacceptance.
Highlights
In the year 2017, approximately 810 women died during child labor on a daily basis, 94% of whom were from developing countries with sub-Saharan Africa and Southern Asia alone contributing 86% [World Health Organization (WHO)] [1]
Determining the obstetric fistula patients’ self-efficacy for reacceptance would bring new insights into appropriate approaches including assessment of their competencies aligned to specific domains mainly social interaction, community engagement, childbearing, meeting needs and being able to live a normal life in the context of each patient
The search with PubMed resulted in 12 papers having used “social reintegration among obstetric fistula patients in Africa” to search
Summary
In the year 2017, approximately 810 women died during child labor on a daily basis, 94% of whom were from developing countries with sub-Saharan Africa and Southern Asia alone contributing 86% [World Health Organization (WHO)] [1]. As labor gets prolonged and obstructed due to feto-pelvic disproportion, the extensive and excessive pressure exerted on the vaginal, urinary, and gastrointestinal tracts by the fetal head against the pelvic walls eventually causes defects in the bladder, ureter, urethra and or rectum This results in continual leakage of urine and or fecal matter through the defects in them connected with the vagina. Shame, stigma, depression, and are unable to work [5, 8, 11] These seriously affect their self-esteem and self-efficacy for a normal social lifestyle, and the ability to meet their goals. Determining the obstetric fistula patients’ self-efficacy for reacceptance would bring new insights into appropriate approaches including assessment of their competencies aligned to specific domains mainly social interaction, community engagement, childbearing, meeting needs and being able to live a normal life in the context of each patient. Little is documented about self-efficacy for reacceptance among obstetric fistula patients in their communities in African settings, which warranted this study
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