Health-seeking experiences of women with obstetric fistula: a qualitative study at two fistula centres in Ghana.

Autor:	Asiedua E; School of Nursing & Midwifery, Department of Maternal and Child Health, University of Ghana, Legon, Ghana easiedua@ug.edu.gh., Maya E; School of Public Health, Department of Population, Family, and Reproductive Health, University of Ghana, Legon, Ghana., Ganle JK; School of Public Health, Department of Population, Family, and Reproductive Health, University of Ghana, Legon, Ghana., Eliason S; School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Ansah-Ofei AM; School of Nursing & Midwifery, Department of Research, Education and Administration, University of Ghana, Legon, Ghana., Senkyire EK; Ga West Municipal Hospital, Ghana Health Service, Accra, Ghana., Adanu R; School of Public Health, Department of Population, Family, and Reproductive Health, University of Ghana, Legon, Ghana.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Aug 17; Vol. 13 (8), pp. e064830. Date of Electronic Publication: 2023 Aug 17.
DOI:	10.1136/bmjopen-2022-064830
Abstrakt:	Objectives: The study explored the health-seeking experiences of women with obstetric fistula from the onset of the condition until surgical treatment was obtained. It also describes their interactions with health staff and traditional healers. Design: Exploratory, descriptive qualitative study. Setting: Two secondary-level health facilities in the northern and central regions of Ghana; data collection took place in 2018-2019. Participants: A purposive sample of 37 women who had experienced fistula resulting from childbirth and were awaiting fistula repair at the two fistula centres in Ghana was obtained. Data Analysis: Thematic analysis was used to analyse the data. Results: Health-seeking experiences and behaviours of women with obstetric fistula were identified. Six major themes were generated: attribution and perceptions of fistula; competing alternatives/multiple sources of care; limited awareness and access to care; financial barriers; psychosocial challenges, and abuse by healers. The results indicate that the health-seeking experiences of women with obstetric fistula were characterised by long delays in care-seeking. The major themes and subthemes are presented with quotes from participants. Conclusion: The women experienced winding pathways of treatment-seeking due to lack of awareness and incorrect attribution. The major barriers to health-seeking included poverty, challenges with transportation and inadequate repair centres. Increased awareness of obstetric fistula and access to repair centres could shorten the suffering women go through while awaiting fistula treatment. Improved awareness of obstetric fistula and establishment of more fistula centres would be beneficial. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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