Extent of involvement in social rehabilitation among obstetric fistula patients at Kitovu Hospital, Uganda.

Abstract

Introduction: Obstetric fistula is highly debilitating with effects acknowledged as beyond treatment thus, it requires physical and social rehabilitation. The study described the extent to which obstetric fistula patients have been involved in social rehabilitation services at Kitovu Hospital in Uganda. Methods: A cross-sectional survey that used mixed methods was done among 390 obstetric fistula patients and 12 key informants at Kitovu Hospital in Uganda. The 390 patients responded to a semi-structured questionnaire, and 10 of them were involved in in-depth interviews. The 12 key informants were hospital staffs actively involved in the management of obstetric fistula, and patients’ partners who were involved in care giving. The variables under investigation included: socio-demographic and obstetric factors alongside whether the patients had been empowered, earned daily, had received aid to startup an income generating activity, had skills training, counseling, physiotherapy, health education, needs assessment and whether their needs had been addressed. Results: Among the 390 participants, 192 (49.2%) had had fistula repair, 198 (50.8%) had not had repair, 215 participants felt they had not been empowered at all, 215 did not earn daily. Again, 211 indicated that they had not received aid to startup an income generating activity, 235 had not received skills training, 195 had not received counseling, and 299 had not had physiotherapy. A significant difference was noted across all the variables (empowerment, daily earning, having received aid to startup an income generating activity, skills training, counseling, physiotherapy, health education, needs assessment and having their needs addressed) and their repair category with a P-value of <0.001. Qualitative findings also indicated that patients received inadequate social rehabilitation due to inadequate resources. Patients preferred fistula repair before they could be socially rehabilitated as they still felt incapacitated. Conclusions: A larger proportion of patients with unrepaired fistula had not been involved in social rehabilitation compared to those whose fistula had been repaired. More repair and rehabilitation centers ought to be constructed and adequately facilitated for the patients to receive the services they desire for effective social rehabilitation.