Complicating causality: patient and professional perspectives on obstetric fistula in Nigeria.
Obstetric fistula, a preventable maternal morbidity characterised by chronic bladder and/or bowel incontinence, is widespread in Nigeria. This qualitative, multi-site study examined the competing narratives on obstetric fistula causality in Nigeria. Research methods were participant observation and in-depth interviews with 86 fistula patients and 43 healthcare professionals. The study found that both patient and professional narratives identified limited access to medical facilities as a major factor leading to obstetric fistula. Patients and professionals beliefs regarding the access problem, however, differed significantly. The majority of fistula patients reported either delivering or attempting to deliver in medical facilities and most patients attributed fistula to a lack of trained medical staff and mismanagement at medical facilities. Conversely, a majority of health professionals believed that women developed obstetric fistula because they chose to deliver at home due to women's traditional beliefs about womanhood and childbirth. Both groups described financial constraints and inadequate transport to medical facilities during complicated labour as related to obstetric fistula onset. Programmatic insights derived from these findings should inform fistula prevention interventions both with healthcare professionals and with Nigerian women.
['Phillips|Beth S|BS|', 'Ononokpono|Dorothy N|DN|', 'Udofia|Nsikanabasi W|NW|']
D000293:Adolescent D000328:Adult D036861:Delivery, Obstetric D005260:Female D005402:Fistula D066296:Grounded Theory D006282:Health Personnel D006297:Health Services Accessibility D006801:Humans D007407:Interviews as Topic D008427:Maternal Health Services D009035:Mothers D009549:Nigeria D007744:Obstetric Labor Complications D011247:Pregnancy D011256:Pregnancy Outcome D036301:Qualitative Research
professional perspectives obstetric fistula Nigeria patient perspectives