Factors Contributing to Obstetrical Fistulas Among Mothers Attending Post Natal Clinic at Jinja Regional Referral Hospital

TABLE OF CONTENTS

DECLARATION............................................................................................................................ i

APPROVAL .................................................................................................................................. ii

DEDICATION..............................................................................................................................iii

ACKNOWLEDGEMENT........................................................................................................... iv

LIST OF TABLES ....................................................................................................................... xi

LIST OF TEXTS......................................................................................................................... xii

DEFINITION OF KEY TERMS..............................................................................................xiii

LIST OF ABBREVIATIONS ................................................................................................... xiv

ABSTRACT................................................................................................................................... 1

CHAPTER ONE: INTRODUCTION......................................................................................... 2

1.1 Background of the study......................................................................................................... 2

1.2 Problem Statement.................................................................................................................. 3

1.3 General Objective ................................................................................................................... 4

1.4 Specific Objectives.................................................................................................................. 4

1.5 Research Questions................................................................................................................. 4

1.6 Conceptual framework.............................................................................................................. 5

1.7 Justification ............................................................................................................................. 6

CHAPTER TWO: LITERATURE REVIEW............................................................................ 7

2.1 Introduction............................................................................................................................. 7

2.2 Social-cultural related factors leading to obstetrical fistulas.............................................. 7

2.3 Socio-economic related factors leading to obstetric fistulae ............................................... 8

2.4 Measures to prevent obstetric fistulas................................................................................... 9

CHAPTER THREE: METHODS AND MATERIALS .......................................................... 12

3.1 Introduction........................................................................................................................... 12

3.2 Study design and rationale................................................................................................... 12

3.3 Study setting and rationale .................................................................................................. 12

3.4 Study population................................................................................................................... 12

3.5 Definition of variables........................................................................................................... 13

3.6 Research Instruments........................................................................................................... 14

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3.7 Data collection procedure..................................................................................................... 14

3.7.1 Data management .............................................................................................................. 14

3.7.2 Data Analysis...................................................................................................................... 14

3.8 Ethical consideration ............................................................................................................ 14

3.9 The study limitations ............................................................................................................ 14

3.10 Dissemination of results’ .................................................................................................... 15

CHAPTER FOUR....................................................................................................................... 16

4.0 RESULTS .............................................................................................................................. 16

4.1 Socio cultural related factors leading to obstetrical fistulas............................................. 16

4.2 Socio-economic related causes of obstetrical fistula .......................................................... 18

4.3 Measures that can be undertaken to prevent obstetrical fistulas..................................... 21

CHAPTER FIVE ........................................................................................................................ 24

5.0 DISCUSSION, CONCLUSION AND RECOMMENDATIONS ..................................... 24

5.1 Discussion............................................................................................................................... 24

5.1.1 Socio cultural related factors leading to obstetrical fistulas.......................................... 24

5.1.2 Socio-economic related causes of obstetrical fistula ....................................................... 25

5.1.3 Measures that can be undertaken to prevent obstetrical fistulas.................................. 28

5.2 Conclusions............................................................................................................................ 30

5.3 Recommendations................................................................................................................. 30

REFERENCES............................................................................................................................ 31

APPENDIX I: STATEMENT OF CONSENT......................................................................... 34

APPENDIX II: QUESTIONNAIRE ......................................................................................... 36

APPENDIX III: MAP OF JINJA DISTRICT SHOWING JINJA HOSPITAL................... 40

APPENDIX IV: MAP OF UGANDA SHOWING JINJA DISTRICT .................................. 41

ABSTRACT Ideally pregnant mothers in labour are to deliver safely without any complications like fistulas under normal circumstances. However, worldwide, obstetrical fistula remains a childbirth injury that has been largely neglected despite the devastating impact it has on the lives of affected girls and women. The purpose of the study was to assess factors contributing to obstetrical fistulas among mothers attending post natal clinic at Jinja Regional Referral Hospital. The study used a descriptive cross sectional design employing quantitative methods of data collection. The study was selected because it helped the researcher to collect data in the shortest period. Thirty respondents were chosen because it helped the researcher to collect data in minimal time. Results: On socio cultural related factors leading to obstetrical fistulas showed that 21/30 (70%) of the respondents have ever seen a woman with a fistula. on whether respondents have nearby health facility in their area, 18/30(60%) of respondents said Yes. According to socio-economic related factors leading to obstetric fistulae, the greatest number of respondents (95%) agreed that lack of essential medical -surgical supplies in health facility can increase the risk of obstetric fistula. Regarding unavailability of specialized personnel, the overwhelming number of respondents (92%) agreed.On Measures to prevent obstetric fistulas, the greatest number of respondents (90%) agreed on creation of tough laws against early marriages and the highest number of the respondents (86%) agreed on availability of emergency obstetrical care. Conclusion; Limited medical- surgical supplies, inadequate CMEs, and understaffing among others predisposed women to obstetric fistulas. Recommendations: Training of health workers on fistula prevention and management, ensuring adequate and medical supplies among others.