Health-seeking experiences of women with obstetric fistula: a qualitative study at two fistula centres in Ghana
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open
Abstract
Objectives The study explored the health-seeking
experiences of women with obstetric fistula from the onset
of the condition until surgical treatment was obtained.
It also describes their interactions with health staff and
traditional healers.
Design Exploratory, descriptive qualitative study.
Setting Two secondary-level health facilities in the
northern and central regions of Ghana; data collection took
place in 2018–2019.
Participants A purposive sample of 37women who had
experienced fistula resulting from childbirth and were
awaiting fistula repair at the two fistula centres in Ghana
was obtained.
Data analysis Thematic analysis was used to analyse the
data.
Results Health-seeking experiences and behaviours of
women with obstetric fistula were identified. Six major
themes were generated: attribution and perceptions of
fistula; competing alternatives/multiple sources of care;
limited awareness and access to care; financial barriers;
psychosocial challenges, and abuse by healers. The results
indicate that the health-seeking experiences of women
with obstetric fistula were characterised by long delays
in care-seeking. The major themes and subthemes are
presented with quotes from participants.
Conclusion The women experienced winding pathways of
treatment-seeking due to lack of awareness and incorrect
attribution. The major barriers to health-seeking included
poverty, challenges with transportation and inadequate
repair centres. Increased awareness of obstetric fistula
and access to repair centres could shorten the suffering
women go through while awaiting fistula treatment.
Improved awareness of obstetric fistula and establishment
of more fistula centres would be beneficial.
Description
Research Article
Keywords
Health-seeking, women, fistula
Citation
To cite: Asiedua E, Maya E, Ganle JK, et al. Health seeking experiences of women with obstetric fistula: a qualitative study at two fistula centres in Ghana. BMJ Open 2023;13:e064830. doi:10.1136/ bmjopen-2022-064830