Exploring Awareness of Obstetric Fistula in Eastern and Northern Nigeria: Perceived Causes, Symptoms, and Availability of Treatment Services

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Abstract Background: Evidence suggests that there are approximately two female genital fistula cases per 1,000 women of reproductive age in sub-Saharan Africa. It is estimated that more than 200,000 women are affected by fistula in Nigeria, primarily due to obstetric causes. This study assessed the awareness of women, men, and caregivers about fistula causes and symptoms, as well as about the availability of and access to services in eastern and northern Nigeria. Methods: A cross-sectional qualitative study was conducted in Kano and Ebonyi states in northern and eastern Nigeria, respectively. Focus group discussions were conducted with women who were successfully repaired and discharged (n=2) and with community-married men (n=2) and women (n=2). In-depth interviews were conducted with 18 women with fistula who were either awaiting repair or had been repaired; six family member caregivers accompanying fistula patients, and 20 health service providers at fistula repair centers. Results: There was poor knowledge of obstetric fistula and its causes among married men and women in the community, caregivers, and some patients were unaware of what caused their fistula for years. In this study, none of the community men and women nor caregivers correctly identified the causes and symptoms of a fistula or knew where to seek treatment. Knowledge about fistula was more common among women who had undergone repairs. Some repaired women attributed the cause of fistula to the providers who attended to them during delivery. Conclusion: Findings reveal a widespread lack of awareness of obstetric fistula onset and awareness of the availability of repair services at the community level. There is an urgent need to explore multi-pronged strategies for increasing awareness of obstetric fistula and available treatment services among women and other community members.

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