What factors contribute to obstetric fistulae formation in rural Kenya?

Abstract

Obstetric fistula, a devastating maternal health complication associated with social stigma and isolation, is often found in resource-poor settings where access to specialized care is constrained. In this study, the authors examine the perspectives of the healthcare providers on the factors that contribute to obstetric fistulae formation in West Pokot, Kenya. Key informant interviews with healthcare providers, social workers and traditional birth attendants were held to generate information on factors contributing to formation of obstetric fistulae. Thematic analysis based on grounded theory approach was used. Factors that contribute to the occurrence of obstetric fistulae include: female genital mutilation and early forced marriage; unskilled birth attendants and associated birth rituals; infrastructural constraints; and lack of women's empowerment. There is interplay between sociocultural, structural and economic forces in the region that culminate in maternal morbidity and possible mortality. Healthcare providers' perspectives are vital in understanding maternal health problems in rural Kenya. Community level initiatives aimed at improving the health of women in rural resource-poor areas should be encouraged.