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Insights from birthing experiences of fistula survivors in North-central Nigeria: Interplay of structural violence

Laurenson, Mary; Degge, Hannah M.; Dumbili, Emeka W.; Hayter, Mark

Authors

Mary Laurenson

Hannah M. Degge

Emeka W. Dumbili



Abstract

Obstetric Fistula is an abnormal opening between the vagina and rectum resulting from prolonged and obstructed labour. Studies indicate that delays in accessing maternal care and home birth contribute to the development of fistula. Survivors are usually women of low socioeconomic status residing in rural locations. This study explores the birthing experiences of 15 fistula survivors through a narrative inquiry approach at a repair centre in North-central Nigeria. Using structural violence as a lens, it describes the role of social, political and health systems in the inequitable access to care for women. For women opting for home births, preference for home delivery was mainly due to lack of finances, poor health systems and cultural practices. Rural location inhibited access as, women seeking facility delivery faced transfer delays to referral centres when complications developed. Inequitable maternal health services in rural locations in Nigeria are inherently linked to access to health care; and these contribute to the increased incidences of fistulae. Structural intervention is a health policy priority to address poor health systems and achieve universal health coverage to address maternal health issues in Nigeria.

Journal Article Type Article
Publication Date 2020
Journal Nursing Inquiry
Print ISSN 1320-7881
Electronic ISSN 1440-1800
Publisher Wiley
Peer Reviewed Peer Reviewed
Article Number e12377
APA6 Citation Laurenson, M., Dumbili, E. W., Degge, H. M., & Hayter, M. (2020). Insights from birthing experiences of fistula survivors in North-central Nigeria: Interplay of structural violence. Nursing Inquiry, https://doi.org/10.1111/nin.12377
DOI https://doi.org/10.1111/nin.12377
Keywords obstetric fistula; structural violence; health systems; maternal health; narrative analysis; Nigeria
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/nin.12377
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