Barriers in seeking fistula repair services among women with obstetric fistula in Zambia: The case of Muchinga, Luapula Eastern and Southern Provinces

Abstract

Background & Aim: Obstetric fistula is a condition in which a hole develops in the birth canal as a result of childbirth resulting in leakage of urine and/or stool through the vagina. Once obstetric fistula occurs, it requires reconstructive surgery as fistulas usually cannot heal by themselves. However, women most women do not seek fistula repair services. Objective: To explore barriers contributing to not seeking fistula repair services among women with obstetric fistula.Methods: This was a qualitative study. The study was conducted between October, 2017 and September, 2018. The study setting was Muchinga, Luapula, Eastern and Southern provinces of Zambia. A purposive sample of 16 participants was recruited and interviewed in their homes. In-depth interviews were conducted. Data was analyzed manually using thematic content analysis.Results: The age of the participants ranged from 19 - 87 years. Six thematic areas were identified that included lack of knowledge that fistula repair services exist, inaccessibility to fistula repair services, health systems barrier, poverty levels, effect of fistula, unsuccessful repairs and cost for transport. Conclusion: Women either delayed in seeking fistula repair services or did not seek the service at all. Strategies such as addressing barriers at individual, family, community, organization and facility levels must be implemented in order to improve access to fistula surgical repair services.