Obstetric fistula: a narrative review of the literature on preventive interventions in sub-Saharan Africa

Abstract

Obstetric fistulas are childbearing injuries that present a major public health issue, especially in the developing context. This study brings together the literature on the causes of these injuries in sub-Saharan Africa, as well as suggested interventions aimed at its prevention. Furthermore, it also aims to identify gaps in the research that need to be addressed. A systematic search of PubMed, Embase, Web of Science, and Scopus identified that extensive research has been carried out on the factors causing this injury, the main factors being complications during labour, three phases of delay, and culture. Nonetheless, there remains a dearth of literature detailing preventive measures. While few studies discussed preventive interventions that had been implemented, the literature does well to suggested preventive interventions. Suggested preventive measures target the community, as well as healthcare facilities. The literature also highlights the need for increased governmental support, as a means of preventing the development of fistulas. Using narrative review methods, we identify that the research focus remains primarily on the causes of obstetric fistula and ways of managing the injury, while paying less attention to means of preventing this injury. We therefore recommend further exploration of preventive measures. 

Keywords: Obstetric fistula, Prevention, Intervention, Sub-Saharan Africa, Maternal health