Risk Factors, Ascribed Causes And Effects Of Obstetric Fistula Among Women In Northern Ghana: A Case Control Studies

Abstract

Background: Obstetric fistula is a demoralizing maternal morbidity. In Ghana, majority of the fistula occur in the northern sector. This study sought to identify the risk factors, ascribed causes and effect of obstetric fistula.
Methods: A matched case control study was conducted from April to June 2013. The fistula patients were taken from the Fistula Centre in Tamale whiles the controls were from the Tamale Teaching hospital. Eligible cases were confirmed fistula patients admitted for fistula repair while controls were women who have delivered but without obstetric fistula. Cases and controls were matched on year, region and district of index delivery.
Results: the following factors were associated with obstetric fistula; age below 20 years, total labour duration more than 24 hours, height 150 cm and below, still birth, operative delivery, residence in a rural area and lack of formal education. Divorce rate among cases over the period was 55.3% while that among the controls was 2.3%. About 20% of cases were likely to be currently using alcoholic beverages compared to 6% in controls (OR=5.3, 95% CI= 1.4 – 19.7). 40% of cases currently have no living child compared to 2% of
controls. Majority of fistula patients blame lack of health facilities and an act of God as a cause of fistula.
Conclusions: Majority of women who suffer obstetric fistula are young, poor, of short stature, illiterate and resident in remote areas. There is widespread lack of understanding of the causes of Obstetric fistula among women.