Social reintegration service after fistula repair and its challenges in North Gondar, Ethiopia: Women’s perspectives: A qualitative study

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Abstract Back ground: Following a fistula repair, there is a need to rehabilitate and reintegrate women into society. Existing interventions are not well documented or not sufficient to maintain victims’ life and in most cases the issue of reintegration depends up on treatment success. Data on how reintegration has fulfilled women’s needs is sparse. Therefore, the aim of this study was to explore the needs and challenges of women on post obstetric fistula repair. Method: A qualitative, phenomenological approach was used through in-depth interviews to explore women`s perspectives on reintegration service. Respondents were selected by purposive and snow ball sampling until data saturation was reached. Women were interviewed at least one year after they obtained surgical correction. Open code version 4.03 and thematic analysis was used to analyze the data. Result: Twelve women after fistula repair were interviewed at different settings; their median age at interview was 27(range 24- 45). Five were fully continent and six claimed to have either stress or urge incontinence. Repair sessions ranged between 1-5surgeries with an average period of 6.25 years after treatment. The meaning attached to reintegration slightly differed between those women who regained continence and those with unsuccessful repair. Surgical correction, resource support and restoration of social health were found to be the most important aspects of the service. Financial difficulty, lack of counseling on fertility needs, lack of individual centered services and residual leaks were commonly reported challenges. Conclusion: Effective reintegration services should meet women’s needs to the level of their anticipation. Challenges inherent in post repair reintegration require appropriate measures to mitigate dependency, loneliness and the recurrence of fistula.

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