Socio-Demographic Factors Influencing Utilization of Obstetric Fistula Services among Women of Reproductive Age in Makueni County, Kenya

Abstract

Obstetric fistula refers to an abnormal hole that connects a woman’s vagina and bladder or vagina and rectum through which urine and/or fecal matter leaks continuously. The underlying causes of obstetric fistula include early marriages, teenage pregnancies, Female Genital Mutilation (FGM), assault and surgical trauma. It is estimated globally that more than half a million women of reproductive age die from complications related to pregnancy and childbirth. Out of this statistic, about 99 percent occur in Sub-Saharan Africa and Asia. This was a descriptive cross-sectional study which was conducted at Makueni County in eastern part of Kenya. This study sought to investigate the socio-demographic factors influencing utilization of Obstetric Fistula services among women of reproductive age in Makueni County.
Materials and Methods: The study used both quantitative and qualitative data collection methods. Quantitative data was collected using semi-structured questionnaires administered by trained Research Assistants. A total of 389 questionnaires were considered fit representing a 92.18% response rate. Quantitative data was cleaned and entered into a Microsoft excel database before being analyzed by SPSS version 22.0. Descriptive statistics were presented using percentages, frequency tables, graphs and pie-charts. Inferential statistics were calculated to establish the association between study variables using chi-square tests done at 95% confidence interval and p-values of less than 0.05 considered statistically significant.
Results:The results revealed that only 32% (95CI, 27% - 37%) of respondents utilized obstetric fistula services in which counseling was the most sought service at 44.4% (95%CI, 36% - 53%).Chi-square analysis showed that there was a significant statistical association between age (p=0.001), level of education (p=0.002), occupation (p=0.001), average monthly family income (p=0.011) and utilization of obstetric fistula services.
Conclusion: The study concludes that there were low utilization rates, low knowledge levels and negative perceptions towards obstetric fistula services. The findings of this study would help relevant stakeholders in structuring programs and strategize on interventions related to creation of community awareness and thus improve the health seeking behaviors towards utilization of obstetric fistulae screening services. These results would also be of use to the Ministry of Health for purposes of health education and for policy formulation and implementation with regards to workable short-term and long-term obstetric fistulae interventions.