Co morbidities associated with vesico vaginal fistula in patients managed in Maryam Abacha Fistula Hospital Sokoto, Northwestern Nigeria

The psycho-social impact of obstetric fistula and available support for women residing in Nigeria: a systematic review

BACKGROUND

Obstetric fistula continues to affect the social and mental wellbeing of women living in Nigeria giving rise to poor maternal health outcome. While the World Health Organisation (WHO) has recommended the introduction of psycho-social interventions in the management of obstetric fistula women, psycho-social support for women living with obstetric fistula in Nigeria, are limited. This systematic review aimed to synthesise the psycho-social impact of obstetric fistula on women living in Nigeria as well as the available psycho-social support for these affected women.

METHODS

Following a keyword strategy, Medline, CINAHL, Google scholar, ScienceDirect, Cochrane library, PsychINFO, AMED, British Nursing database, Pubmed central, TRIP database, UK Pubmed central, socINDEX, Annual reviews, ISI Web of Science, Academic search complete, Credo reference, Sage premier and Scopus databases were searched alongside hand searching of articles. The inclusion criteria were set as articles published between 2000 and 2020, on the psychosocial consequences of obstetric fistula in Nigeria. The Critical Appraisal Skills Program (CASP) tool was used to appraise the quality of the included studies. The data was extracted and then analysed using narrative synthesis.

RESULTS

620 relevant citations were identified, and 8 studies were included. Women with obstetric fistula, living in Nigeria were found to be ostracised, abandoned by families and friends, stigmatised and discriminated against, which led to depression, loneliness, loss of self-esteem, self-worth and identity. Psycho-social interventions for women who experienced obstetric fistula are not widely available.

CONCLUSION

There is a need for the introduction of more rehabilitation and reintegration programs across the country. The psychosocial effect of obstetric fistula is significant and should be considered when developing interventions. Further, more research is needed to evaluate the sustainability of psychosocial interventions in Nigeria.

Health disclosure mediates stigma-psychological well-being link among Vesico-Vaginal fistula patients

There is strong link between health stigma and poor psychological wellbeing among Vesico-Vaginal fistula (V.V.F.) patients, yet no study to date has investigated the variables mediating this link. This study investigated the mediating role of health disclosure on the relationship between health stigma and psychological wellbeing among V.V.F. patients in Nigeria. Participants were 183 women (aged 14-70 years; mean age 22.88 years, SD = 5.64) conveniently drawn from a National Obstetric Fistula Hospital facility in south-east Nigeria. Participants completed measures of health stigma, health disclosure and psychological wellbeing. Results showed that health disclosure mediated the association between health stigma and psychological wellbeing. The results indicated that increased health stigma would lead to decreased health disclosure which in turn, would lead to poor psychological wellbeing. Our findings highlighted the relevance of health disclosure in the management of stigma impacts on health and wellbeing of V.V.F. patients.