Obstetric fistula- related knowledge, attitudes and practices of females and males in the Zabzugu-Tatale District, Northern Region, Ghana

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November, 2016.
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For far too long, the problem of obstetric fistula has been illusive, and largely clouded in myths and mystery. The process of injury affecting the genitourinary system and anal canal, parts of the body usually covered from view of others. Victims of obstetric fistula therefore endure the injuries in silence, coupled with shame, pain and discomfort. Individuals affected are often stigmatized and discriminated against by relatives and community members. This has become imperative necessitating the focus of this study to determine the awareness of obstetric fistula condition among women and men of fertility age. The study aimed at determining the knowledge, attitudes and practices among women and men of reproductive age in the Zabzugu-Tatale district towards obstetric fistula condition. A cross-sectional survey was conducted among women and men of reproductive age in the district. A total of 110 residents were interviewed face to face using structured questionnaires to obtain biodata and other data related to maternal health and fistula condition. Out of the 110 study participants interviewed 69 (62.73%) have heard of obstetric fistula (OF), mainly from health workers (29.09%) and family members (29.09%). More than 80% of the participants did not agree that poor obstetric care was a possible cause of obstetric fistula. Only 11.7% of the study participants agreed that prolonged labour was a possible cause of obstetric fistula, while 17.3% agreed that teenage pregnancy was a cause. Many (35-45%) of the participants consider obstetric fistula medium for birth injury, a case for divorce, a curse and social problem. Most respondents (89.1%) perceived trained health professionals to be the best safety method for delivery while 5.5% would prefer mother-in-laws and 4.5% from TBA. Also, 85.5% would choose a health facility over other sources for delivery while 17.3% perceived OF as a curse. Prevention of the disease was also identified to be possible through delay of early marriage and pregnancies, good spacing of births, delivery at health facilities, and avoiding pregnancies at age 40 or higher among others. Spousal influence on maternal health care seeking behaviour was considered necessary but not so in the Zabzugu/Tatale community. This study shows that awareness of obstetric fistula in the study community was high however; participants have rudimental and fair knowledge of the possible causes and complications that lead to the condition. The findings further highlight lack of knowledge of the participants on the causes of obstetric fistula and practices for its prevention. There is the need to scale up public health and maternal health education on obstetric fistula.
A thesis submitted to the Department of Health Policy, Management and Economics, College of Health Sciences, School of Public Health, in partial fulfilment of the requirements for the degree of master of public health in Health Services Planning and management.