Life after fistula: experience of women after fistula repair at kibagabaga district hospital, Rwanda

Abstract

Background: Obstetric fistula affects an estimated 2-3 million women globally, mostly in sub- Saharan Africa and Asia (WHO, 2014). Women with fistula tend to have both positive and negative experiences. While programs for fistula repair exist in Rwanda, the experience of women after the repair of fistula including integrating within the family and the community is not known. Objective: To explore the lived experiences of women being reintegrated into family and the communities after fistula repair at Kibagabaga District Hospital. Methodology: Qualitative study with a phenomenological approach was used. An in-depth interview was performed in 20 women from January 26th to February 6th at Kibagabaga District Hospital Rwanda. This was a group of women who had come back for follow-up three months after fistula repair. Thematic analysis was used for data analysis. Results: Two themes were identified: immediate women’s experiences and social integration. The immediate women's experience included the categor y of the miracle phase and interaction with the health system. The social reintegration included a category of positive and negative experience. The category of positive experience included subcategories of resumption of roles, family positive experience, and community positive experience. The category of negative experience had 4 subcategories: Isolation, financial constraints, family negative experience, and community negative experience. Conclusion: The study demonstrates women’s feelings and emotions after fistula repair and the pathway to social reintegration in the community. The women in this study experienced psychological challenges including stigma and isolation, disrupted the marital relationship, divorce, social-economic challenges such as powerlessness, inability to work, over dependency, limited social support, financial constraints and, profound poverty. There is no organized social reintegration process for women following fistula repair, many women found it hard to be get reintegrated into their communities after repair.