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An integrative review on women living with obstetric fistula and after treatment experiences

Mafo Degge, Hannah; Hayter, Mark; Laurenson, Mary


Hannah Mafo Degge

Mark Hayter

Mary Laurenson


Aims and objectives. To review literature on the experiences of women with obstetric fistula, their lived experiences after treatment; and to provide evidence for future research. Background. Obstetric fistula is an injury most commonly resulting from a pro-longed labour. Long eradicated in developed countries, obstetric fistula remains a public health issue in sub-Saharan Africa and Asia. This is a highly stigmatised health condition, and an understanding of the women’s experience is required to inform holistic approaches for care and prevention. Design. An integrative review. Data sources. EBSCO host (Academic Search Premier, MEDLINE, PsychINFO, CINAHL), Web of Science; Grey literature and websites of international organisa-tions such as Women’s Dignity Project and EngenderHealth. Keywords, inclusion and exclusion criteria were defined and 25 articles published from 2004–January 2015 were identified. Review method. The review was guided by Whittemore and Knafl’s revised ana-lytical framework. All articles were assessed for methodological quality and criti-cally analysed to elicit emergent themes and subthemes. Results. Three broad themes were identified: challenges of living with fistula; treatment and care experiences; and reintegration experiences of women after fis-tula repair. Conclusions. Living with a fistula presents multidimensional consequences affect-ing women, families and communities. Accessing treatment is difficult, and there are no standardised treatment packages. Surgical repairs were variable in their success rate. Some authors claim women resume normal lives irrespective of their continence status, whilst others claim they face discrimination despite being conti-nent, thereby hindering reintegration. Quality of life is diminished for those remaining incontinent. Postrepair psychosocial support services are beneficial for reintegration, but research on programme benefits is limited. Therefore, further research is required to support its benefits and for policy development to meet care provision for women with fistula.


Mafo Degge, H., Hayter, M., & Laurenson, M. (2017). An integrative review on women living with obstetric fistula and after treatment experiences. Journal of clinical nursing, 26(11-12), 1445-1457.

Journal Article Type Article
Acceptance Date Sep 22, 2016
Online Publication Date Mar 10, 2017
Publication Date Jun 1, 2017
Deposit Date Oct 11, 2016
Publicly Available Date Mar 10, 2017
Journal Journal of clinical nursing
Print ISSN 0962-1067
Electronic ISSN 1365-2702
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 26
Issue 11-12
Pages 1445-1457
Keywords Holistic care; Integrative review; Obstetric fistula; Postrepair care; Quality of life; Rehabilitation; Reintegration
Public URL
Publisher URL;jsessionid=402FFB21FA60D9CB4965D1781F18F8EF.f03t04
Additional Information This is a description of an article published in: Journal of Clinical Nursing, 2017, v.26 issue 11-12.


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