ABSTRACT
Background: Obstetric fistula is a breach in the birth duct by means of undue labor
without appropriate and prone health aid. It is an obstructed labor lacking well-timed
health interference, usually caesarean section. This is a condition where the baby
always dies during labor. In the condition the woman concern is generally left with
internal wound that leaves her leaking urine and waste.
Objectives: The aim and objective is to assess the factors responsible for obstetric
fistula among women. To find out the categories of women who suffered more from
the disease. To find out ways of preventing occurrences of obstetric fistula.
Design: The research design is descriptive. It will assess the characteristics of
women suffering from obstetric fistula. Data in respect of their place of birth,
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presence of a skilled birth attendant, the duration of labor, mode of delivery, the
presence of antennal care, the age at marriage, the age of first delivery.
Settings of research study: This research was carried out in Gambo Sawaba General
Hospital (GSGH), Kofan Gaya Zaria city.
Population: The population of this study was 17 which included two doctors, a nurse
and 14 women who were registered in GSGH and had obstetric fistula.
Method: With permission from the GSGH, two set of questionnaires were
distributed to the patients with obstetric fistula and the other for doctor and a nurse
were used. The questionnaires were structured in order to attain general data
regarding obstetric fistula. This patient’s survey was used to assess the knowledge of
the patients on obstetric fistula.
Result of research study: From the result gotten, lack of adequate ante-natal care
contributed to the occurrence of obstetric fistula in Zaria. Also lack of education and
the fact that women got married at early ages contributed significantly to the
prevalence of obstetric fistula in Zaria and its neighbouring villages.
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Table of Contents
Title page ……………………………………………………………………………………………………. i
Certification……………………………………………………………………………………………….. ii
Reader’s approval……………………………………………………………………………………….. iii
Dedication …………………………………………………………………………………………………. iv
Acknowledgement ………………………………………………………………………………………. v
Abstract ……………………………………………………………………………………………………. vi
Table of contents ……………………………………………………………………………………….. vii
1. CHAPTER 1 (Introduction …………………………………………………………………….. 1
1.1 Statement of the problem ………………………………………………………………………. 1
1.2 Aims and objectives of the study …………………………………………………………….. 2
1.3 Research Questions ……………………………………………………………………………….. 2
1.4 Hypothesis ……………………………………………………………………………………………. 3
1.5 Assumptions of the study ……………………………………………………………………….. 4
1.6 Significance of study ……………………………………………………………………………… 4
2. CHAPTER 2 (Review of related literature)
2.1 Introduction ………………………………………………………………………………………….. 5
2.2 Obstetric fistula ……………………………………………………………………………………. 5
2.3 How many grieve from obstetric fistula? …………………………………………………. 7
2.4 Epidemiology of obstetric fistula …………………………………………………………….. 8
2.5 Causes of obstetric fistula ………………………………………………………………………. 9
2.6 Pathophysiology …………………………………………………………………………………… 13
2.7 Medicosocial Factors in the etiology of Vesicovaginal Fistula …………………… 15
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2.8 Prevention of Obstetric Fistula ……………………………………………………………… 18
2.9 Treatment ……………………………………………………………………………………………. 21
3. CHAPTER 3 (Research Methodology)
3.1 Introduction …………………………………………………………………………………………. 25
3.2 Research design ……………………………………………………………………………………. 25
3.3 Study setting ………………………………………………………………………………………… 26
3.4 Population of the study …………………………………………………………………………. 26
3.5 Sample and sampling technique …………………………………………………………….. 27
3.6 Instrumentation ……………………………………………………………………………………. 28
3.7 Validity of the instrument ……………………………………………………………………… 29
3.8 Administration of the questionnaires ………………………………………………………. 29
3.9 Method of data collection………………………………………………………………………. 29
4. CHAPTER 4
4.1 Data presentation and analysis ……………………………………………………………….. 30
4.2 Results of findings ……………………………………………………………………………….. 32
5. 5 CHAPTER 5 (Conclusion)
5.1 Introduction to chapter ………………………………………………………………………….. 35
5.2 Discussion and summary of findings ………………………………………………………. 35
5.3 Conclusion …………………………………………………………………………………………. 37
5.4 Recommendations ……………………………………………………………………………….. 38
5.5 Suggestions for the study ………………………………………………………………………. 39
5.6 Appendix …………………………………………………………………………………………….. 40
5.7 Reference ……………………………………………………………………………………………. 44
1
CHAPTER ONE
Introduction
The importance of adequate health care to citizens of all nations cannot be
over-stressed. The provision of adequate health care contributes immensely to the
overall development of any nation. Similarly, poor health delivery contributes
negatively to the development of a nation.
The prevalence of obstetric vesicovaginal fistula (VVF) in developing
countries particularly among young women has become a major health problem that
deserves serious attention by government of such countries. According to World
Health Organization (WHO) obstructed labor contributes significantly to maternal
death (WHO, 2014). In Nigeria, because of its prevalence, obstetric vesicovaginal
fistula particularly in the northern states, due consideration is given to obstetric
fistula by World bodies such as United States Agency for International Development
(USAID). For example, in one of its projects in 2013, about 2822 women were
treated obstetric fistula (USAID, 2013).
1.1 Statement of the problem
Due to the persistence of VVF in emerging countries, Nigeria inclusive, it becomes
imperative to study this phenomenon because of its likely negative impact on the
affected population. The rising number of the cases of obstetric VVF particularly in
the northern part of Nigeria makes it necessary to undertake this study. This is further
justified by the revelation of USAID of 50,000 to 100,000 cases and with new ones
yearly. The assessments of the prevalence and knowledge of obstetric VVF in Zaria,
Kaduna State which, is in the Northern part of Nigeria, mostly affected by the
disease makes it worthwhile.
2
1.2Aims and Objectives of the study:
This study is concerned with the prevalence of obstetric VVF and factors
responsible for its occurrence among women in Kaduna state. It also centers on the
categories of women that suffer from the disease and finding ways of preventing the
occurrence of the disease among women in Kaduna state, which is the focus of the
study. It is for these obvious reasons that the study concentrates on Gambo Sawaba
General Hospital Zaria, Kaduna State; a major service point for fistula surgery. The
research design of the study is descriptive. It assesses the characteristics of women
suffering from obstetric fistula. Data in respect of their place of birth, presence of a
skilled birth attendant, the duration of labor, mode of delivery, the presence of
antennal care, the age at marriage and the age of first delivery.
1.3Research questions
The study dwells on research questions such as:
1. What are the causes of obstetric VVF?
2. What are some of the preventable measures of obstetric VVF?
3. What are some of the treatment measures of obstetric VVF?
4. What are the categories of women that suffer from obstetric VVF?
3
1.4 Hypothesis
The following hypothesis are proffered for the study:
1. Early marriage contributes significantly to the prevalence of obstetric fistula
in Zaria and its environs. It is a common tradition among the indigenes of
Zaria local government and its neighboring villages to marry off girls at a
very young age, and this is because the people do not really understand the
outcomes of giving birth at a young age.
2. Illiteracy has direct relationship with the occurrence of obstetric fistula. Lack
of knowledge and information on obstetric fistula will be the major factor that
drives the occurrence of the disease.
3. Lack of adequate ante-natal care contributes greatly to the occurrence of
obstetric fistula in Zaria and its environs.
4
1.5Assumptions of the study:
The study assumes that obstetric fistula has negative effect on the affected
women. Besides, psychological problems it can also impact negatively on the
productivity and wellbeing of the affected women (patients). This can also affect the
population growth of women in the affected area
1.6Significance of the study:
This study contributes to body of knowledge in area of obstetric VVF. It provides
systematic analysis of obstetric VVF and areas where future studies can be carried
out. These areas include the impact of obstetric VVF on population growth of
women.
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