Psychological distress in women with obstetric fistula in Ethiopia: a multi-center, facility-based, cross-sectional study


Abstract Background: Women with obstetric fistula share a common experience of physical and psychosocial morbidity, social isolation, and rejection by family and local society. However, there are only a few studies that focus on women with this condition in Ethiopia. Accordingly, the aim of this study was to examine the presence of psychological distress in women with obstetric fistula in Ethiopia.  Methods: The study employed a multi-center, facility-based, cross-sectional study design. The study was conducted at six fistula repair hospitals in Ethiopia and 219 women with obstetric fistula took part in the study. The data were collected during the women’s admission for obstetric fistula surgical repair. A structured questionnaire was used to obtain socio-demographic information and the medical history of the respondents. Symptoms of depression and anxiety over the past two weeks were measured using the Patient Health Questionnaire and the Generalized Anxiety Disorder scales, respectively. We chose the score cut-off point of 10 or above to define the symptoms over the past two weeks. The data were entered into Epi-Data version 3.2 software and exported to SPSS version 20 for further analysis. Results: Of the 219 women interviewed, 58% and 47% reported a history of symptoms of depression and anxiety, respectively. They also reported significantly lower social support. Symptoms of anxiety and depression were significantly associated with social support (P = 0.008, P = 0.001). Conclusions: Women with obstetric fistula are predisposed to high levels of psychological distress. Clinicians should manage women with obstetric fistula through targeted and integrated mental health interventions to address their mental health needs.  [Ethiop. J. Health Dev. 2018;32(4):107-114] Key words: Anxiety, depression, Ethiopia, obstetric fistula, women