Chi Chiung Grace Chen1, Jie Jiao2, Gerard Mbabazi3, Annelise Long4, Rachel Galvao4, Denis Rwabizi3, Blaise Dushimiyimana3, Eugene Ngoga5. 1. Department of Gynecology & Obstetrics, Johns Hopkins School of Medicine, 301 Building room 3118 4940 Eastern Ave, Baltimore, MD, 21224, USA. cchen127@jhmi.edu. 2. Department of Obstetrics & Gynecology, Wayne State University/Detroit Medical Center, Detroit, USA. 3. Department of Obstetrics & Gynecology, University of Rwanda, Kigali, Rwanda. 4. Department of Gynecology & Obstetrics, Johns Hopkins School of Medicine, 301 Building room 3118 4940 Eastern Ave, Baltimore, MD, 21224, USA. 5. Rwanda Society of Obstetricians and Gynecologists, Kigali, Rwanda.
Abstract
INTRODUCTION AND HYPOTHESIS: To describe the knowledge and perceptions of obstetric fistula (OF) among affected and unaffected women. METHODS: Twenty-five semi-structured interviews were conducted with women who had received OF repair. Three focus groups were conducted: one group of women with urinary incontinence but no OF, one group of women with OF, and one group of women without genitourinary complaints. Interviews and focus groups were conducted using the grounded theory approach. This study took place in two urban hospitals in Rwanda from April to November 2015. Transcripts were coded using MAXDA11 and analyzed using the axial technique and the constant comparative method. RESULTS: Nearly all participants correctly described OF and its symptoms, and 93% of interviewed women attributed OF to complications in vaginal delivery or cesarean section. Several participants described renouncing stigmatizing beliefs after learning about OF from the radio, health workers, or word of mouth. Still, it was found that women with OF were more knowledgeable about OF etiology than women without genitourinary conditions. CONCLUSIONS: Compared to prior studies, women's knowledge about OF appears to be more medically based, with media and health workers playing a role in reducing stigmatizing beliefs. These findings support continued investment in OF awareness campaigns, which seem to be increasing knowledge about OF and reducing stigma.
INTRODUCTION AND HYPOTHESIS: To describe the knowledge and perceptions of obstetric fistula (OF) among affected and unaffected women. METHODS: Twenty-five semi-structured interviews were conducted with women who had received OF repair. Three focus groups were conducted: one group of women with urinary incontinence but no OF, one group of women with OF, and one group of women without genitourinary complaints. Interviews and focus groups were conducted using the grounded theory approach. This study took place in two urban hospitals in Rwanda from April to November 2015. Transcripts were coded using MAXDA11 and analyzed using the axial technique and the constant comparative method. RESULTS: Nearly all participants correctly described OF and its symptoms, and 93% of interviewed women attributed OF to complications in vaginal delivery or cesarean section. Several participants described renouncing stigmatizing beliefs after learning about OF from the radio, health workers, or word of mouth. Still, it was found that women with OF were more knowledgeable about OF etiology than women without genitourinary conditions. CONCLUSIONS: Compared to prior studies, women's knowledge about OF appears to be more medically based, with media and health workers playing a role in reducing stigmatizing beliefs. These findings support continued investment in OF awareness campaigns, which seem to be increasing knowledge about OF and reducing stigma.