Women's Intention to Prevent Vesico Vaginal Fistula Recurrence in Two Repair Centres in Zambia

Abstract

Objective : The study purpose was to determine the association between intention to prevent Vesico-Vaginal Fistula recurrence and knowledge of the risk factors of Vesico Vaginal Fistula recurrence, attitude towards Vesico Vaginal Fistula prevention and self esteem among women with Vesico-Vaginal Fistula in two repair centers in Zambia. Design : This was a descriptive cross sectional correlational study in which data were obtained through the structured interview schedule. Main Outcomes : Vesico vaginal fistula has been recognized as a preventable tragedy and a challenge in areas where access to health care with emergency obstetric care is poor. The situation is getting worse among women, and the key to ending fistula is to prevent it. Measures : The Ministry of Health need to introduce waiting homes in hospitals with emergency obstetric care so that repaired women with VVF can wait for delivery. The MOH needs to support community sensitization or public education on attitudes towards Vesico vaginal fistula prevention which will in turn improve intentions to prevent Vesico vaginal fistula recurrence. Management at katete and Chilonga mission hospitals should ensure that counseling services are intensified to women with a repaired VVF so as to prevent recurrence. Antenatal clinics should be used as an opportunity for teaching Vesico Vaginal fistula since the study finding review that 45% of the respondents did not know the risk factors of recurrence. Results : Majority of the respondents (97%) had positive intentions to prevent VesicoVaginal Fistula recurrence. More than half of the respondents (55%) knew the risk factors of VVF recurrence, 61% had positive attitudes towards Vesico Vaginal Fistula prevention and 52% had low level of self esteem. There was a significant positive relationship between intention to prevent Vesico Vaginal Fistula recurrence and attitude towards Vesico Vaginal Fistula prevention and a significant negative relationship between intention to prevent Vesico Vaginal Fistula recurrence and self esteem. Knowledge of the risk factors of Vesico vaginal fistula recurrence was not significant. Using multiple regressions, attitude and self esteem were significant explaining 15% of the variance in intention to prevent VVF recurrence. Conclusion : Vesico vaginal fistula is a very unpleasant experience for women. Corrective measures have been started by UNFPA but these need to be strengthened. There is need for innovation to consider other solutions that has not been tried before. This is important in order to prevent recurrence of Vesico vaginal fistula among repaired women in subsequent pregnancies.