Socioeconomic implications of obstetric fistula among women treated at gynocare fistula centre, Eldoret Kenya

Abstract

Introduction: The study focused on the socioeconomic status of obstetric fistula patients treated in Gynocare Fistula Centre located in Uasin Gishu County, Kenya. Specifically the study sought to determine demographic characteristics of women admitted with obstetric fistula (OF), assess the socio-cultural characteristics and to describe the psycho-social and economic conditions faced by obstetric fistula women treated at Gynocare. Methodology: The study used quantitative method, guided by in-depth interviews, questionnaires, and key informant. The main focus was on women with fistula who had come for repair services at the centre and whose fistula was primarily as a result of obstetric fistula. Data was collected from one hundred and thirty eight women with fistula, and seven key informants including two nurses, two doctors, one administrator and two social work officers’ at the repair centre. Finding and Discussion: The findings of the study shows that (44%) of the respondents had one to three children while (41%) had no living children. More than one third of the respondents (39%) attended antenatal clinic four times in the most recent pregnancy that resulted in the development of (OF). Majority (80%) of the respondents delivered at the hospital while (7%) were attended to by skilled birth attendants during delivery. More than two thirds of the respondents (69%) were in labour for more than 24 hours. Some of the women with fistula realize leakage of stool and urine within 2 to 8 days post-delivery. This experience predisposes them to social stigma and relationship problems with their spouses. The major social impact to women with OF was established to include stigmatization and isolation by community, divorce by spouse and fear to participate in social events by the affected women. There is reduction (69%) in participation of women with fistula in community groups after sustaining fistula. Economic implications of (OF) to women include loss of income; leadership roles in community development groups and selfesteem that make many women with the condition disembark their income generating activities. Stigma associated with OF causes the clients to live a life of isolation and many lost their livelihoods as a result. Therefore successful repair of fistula brings a lot of joy and a renewed hope not only for the survivor but also to her immediate family. There is however, the need to assist the fistula survivors fit back into community life by equipping them with skills that they can use to become financially empowered. Conclusion: Obstetric fistula is an inequality issue and most of the challenges can be prevented with increased awareness, better referral between hospitals and quality care. Treatment of fistula must go beyond the closing of a physical hole, but address physical, psycho-social and economic challenges to completely rehabilitate the individual affected after repair