Impact of Beyond Fistula programming on economic, psychosocial and empowerment outcomes following female genital fistula repair: A retrospective study.
Kenya
economic empowerment
female genital fistula
mental health
obstetric fistula
psychosocial support
reintegration
vocational training
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
25 Sep 2023
25 Sep 2023
Historique:
revised:
25
08
2023
received:
17
02
2023
accepted:
29
08
2023
medline:
25
9
2023
pubmed:
25
9
2023
entrez:
25
9
2023
Statut:
aheadofprint
Résumé
To retrospectively assess changes in economic status, psychosocial status and empowerment among women who participated in Beyond Fistula reintegration programming following fistula repair. We conducted a retrospective study among 100 Beyond Fistula program participants capturing sociodemographic characteristics, obstetric and fistula history, program participation, and our primary outcomes: economic status, psychosocial status, and empowerment via quantitative survey at two time points: before program participation and currently. Data were collected from November 2020 to July 2021 from 2013 to 2019 program participants. We compared outcomes across these two time points using paired t tests or McNemar's tests. The proportion of individuals owning property (28.0% vs. 38.0%, P = 0.006), having a current source of income (19.0% vs. 56.0%, P < 0.001), and saving or investing income (11.0% vs. 37.0%, P < 0.001) increased significantly from pre- to post-programming. We also identified statistically significant increases from pre- to post-programming in self-esteem (5.0 [IQR 4.0-5.0] vs. 5.0 [IQR 5.0-5.0], P < 0.001), reintegration (53.0 [IQR 43.0-69.0] vs. 65.0 [IQR 51.0-72.0], P < 0.001) and level of input into household economic decision making (2.0 [SD 1.0] vs. 2.3 [SD 1.0], P = 0.004). Beyond Fistula programming likely improved economic status, psychosocial status, and empowerment of participants. Post-surgical interventions incorporating a holistic approach can advance recovery through supporting psychosocial and economic wellbeing and should be offered to women undergoing genital fistula repair.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Références
Stanton C, Holtz SA, Ahmed S. Challenges in measuring obstetric fistula. Int J Gynaecol Obstet. 2007;99(Suppl 1):S4-S9.
Tuncalp O, Tripathi V, Landry E, Stanton CK, Ahmed S. Measuring the incidence and prevalence of obstetric fistula: approaches, needs and recommendations. Bull World Health Organ. 2015;93(1):60-62.
de Bernis L. Obstetric fistula: guiding principles for clinical management and programme development, a new WHO guideline. Int J Gynaecol Obstet. 2007;99(Suppl 1):S117-S121.
United Nations General Assembly. Intensifying Efforts to End Obstetric Fistula within a Decade. Report of the Secretary-General. A/75/264. United Nations; 2020.
Wall LL. Preventing obstetric fistulas in low-resource countries: insights from a Haddon matrix. Obstet Gynecol Surv. 2012;67(2):111-121.
Adler AJ, Ronsmans C, Calvert C, Filippi V. Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013;13:246.
Kenya National Bureau of Statistics, Ministry of Health, National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development, International TDPI. Kenya Demographic and Health Survey 2014. Kenya National Bureau of Statistics, ICF International; 2015.
Arrowsmith S, Hamlin EC, Wall LL. Obstructed labor injury complex: obstetric fistula formation and the multifaceted morbidity of maternal birth trauma in the developing world. Obstet Gynecol Surv. 1996;51(9):568-574.
El Ayadi AM, Barageine JK, Miller S, et al. Women's experiences of fistula-related stigma in Uganda: a conceptual framework to inform stigma-reduction interventions. Cult Health Sex. 2019;1-16:352-367.
Bangser M. Obstetric fistula and stigma. Lancet. 2006;367(9509):535-536.
Ahmed S, Holtz SA. Social and economic consequences of obstetric fistula: life changed forever? Int J Gynaecol Obstet. 2007;99(Suppl 1):S10-S15.
Bashah DT, Worku AG, Yitayal M, Azale T. The loss of dignity: social experience and coping of women with obstetric fistula, in Northwest Ethiopia. BMC Womens Health. 2019;19(1):84.
UN Women Kenya Country Office, Kenya National Bureau of Statistics. Kenya National Gender Statistics Assessment 2018. UN Women Kenya; 2019.
Kenya National Bureau of Statistics, Ministry of Health/Kenya, National AIDS Control Council/Kenya, Kenya Medical Research Institute, Population NCf, Development/Kenya. Kenya Demographic and Health Survey 2014. Kenya National Bureau of Statistics, ICF International; 2015.
Wesangula D. As surgeries triple, Kenya aims to end shame of fistula. Reuters; 2017.
Pollaczek L, El Ayadi AM, Mohamed HC. Building a country-wide Fistula Treatment Network in Kenya: results from the first six years (2014-2020). BMC Health Serv Res. 2022;22(1):280.
Hedges L. Kenya's fight against fistula. Independent. 2018. https://www.independent.co.uk/happylist/kenya-s-fight-against-fistula-a8198671.html
Direct Relief, Fistula Foundation. Global Fistula Hub 2022. https://www.globalfistulahub.org/
El Ayadi AM, Barageine J, Korn A, et al. Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study. Tropical Med Int Health. 2019;24(1):53-64.
El Ayadi AM, Painter CE, Delamou A, et al. Rehabilitation and reintegration programming adjunct to female genital fistula surgery: a systematic scoping review. Int J Gynaecol Obstet. 2020;148(Suppl 1):42-58.
Lombard L, de St JJ, Geddes R, El Ayadi AM, Grant L. Rehabilitation experiences after obstetric fistula repair: systematic review of qualitative studies. Tropical Med Int Health. 2015;20(5):554-568.
Ruder B, Cheyney M, Emasu AA. Too long to wait: obstetric fistula and the sociopolitical dynamics of the fourth delay in Soroti, Uganda. Qual Health Res. 2018;28(5):721-732.
Baker Z, Bellows B, Bach R, Warren C. Barriers to obstetric fistula treatment in low-income countries: a systematic review. Tropical Med Int Health. 2017;22(8):938-959.
Pinchoff J, Austrian K, Rajshekhar N, et al. Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements. BMJ Open. 2021;11:11.
Wangari ENGP, Abuor AA, Wambui J, et al. Kenya's response to the COVID-19 pandemic: a balance between minimising morbidity and adverse economic impact [version 2; peer review: 2 approved, 2 approved with reservations]. AAS Open Res. 2021;4:3.
Pape UJ, Delius AJS, Khandelwal R, Gupta R. Socioeconomic Impacts of COVID-19 in Kenya. World Bank Group; 2021.
Kenya MoPSaGRo. Statement on Increased Gender-based Violence in the Country 2021. http://gender.go.ke/statement-on-increased-gender-based-violence-in-the-country/
PMA Agile/Gender, ICRHK. Gender & COVID-19 Study: Key Results Brief. Bill Melinda Gates INstitute for Population and reproductive Health, Johns Hopkins University Bloomberg School of Public Health & International Centre for Reproductive Health Kenya; 2021.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381.
El Ayadi A, Nalubwama H, Barageine J, et al. Development and preliminary validation of a post-fistula repair reintegration instrument among Ugandan women. Reprod Health. 2017;14(1):109.
Croft TN, Marshall AMJ, Allen CK. Guide to DHS Statistics. ICF; 2018.
Johnson KA, Turan JM, Hailemariam L, Mengsteab E, Jena D, Polan ML. The role of counseling for obstetric fistula patients: lessons learned from Eritrea. Patient Educ Couns. 2010;80(2):262-265.
Ojengbede OA, Baba Y, Morhason-Bello IO, et al. Group psychological therapy in obstetric fistula care: a complementary recipe for the accompanying mental ill health morbidities? Afr J Reprod Health. 2014;18(1):155-159.
Watt MH, Mosha MV, Platt AC, et al. A nurse-delivered mental health intervention for obstetric fistula patients in Tanzania: results of a pilot randomized controlled trial. Pilot Feasibility Stud. 2017;3:35.
Browning A, Menber B. Women with obstetric fistula in Ethiopia: a 6-month follow-up after surgical treatment. BJOG. 2008;115:1564-1569.
Landry E, Frajzyngier V, Ruminjo J, et al. Profiles and experiences of women undergoing genital fistula repair: findings from five countries. Glob Public Health. 2013;8(8):926-942.
Wilson SM, Sikkema KJ, Watt MH, Masenga GG, Mosha MV. Psychological symptoms and social functioning following repair of obstetric fistula in a low-income setting. Matern Child Health J. 2016;20(5):941-945.
Beegle K, Christiaensen L. Accelerating Poverty Reduction in Africa. World Bank; 2019.
Tripathi V, Emasu A, Arnoff E, Mukisa R, Kanakulya H, Kirya F. Improving quality of life for women with incurable fistula in Uganda. 7th Conference of the Iternational Society of Obstetric Fistula Surgeons December 2018; Kathmandu, Nepal, 2018.
Frajzyngier V, Ruminjo J, Barone MA. Factors influencing urinary fistula repair outcomes in developing countries: a systematic review. Am J Obstet Gynecol. 2012;207(4):248-258.