Provider Perspectives on Persistent Urinary Incontinence Following Obstetric Fistula Repair in Ethiopia

Laura E. Jacobson, Melaku Abriha Marye, Elena Phoutrides, Rahel Nardos

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Each year an estimated 50,000 to 100,000 women worldwide are affected by obstetric fistula. This devastating but preventable maternal morbidity leaves women incontinent, stigmatized, isolated, and often with a still birth. While fistula rates in Ethiopia have declined in recent years, estimates range from 7 to 40 percent of women suffer from persistent urinary incontinence after successful closure of their fistula. Few studies have focused on the unique experiences and challenges that providers face treating fistula patients, particularly those who experience persistent urinary incontinence. The goal of this research is to characterize the fistula provider's accounts of how to manage, support, and understand their patient's experience. Semi-structured interviews were conducted with a purposive sample of fistula care providers in Mekelle and Addis Ababa, Ethiopia. The main themes that emerged were a perceived exacerbated impact on quality of life for women with persistent urinary incontinence; a “double hit” of isolation from both their community and from other recovered fistula patients; how the church both influences how patients internalize their injury and provides them with hope and support; and the need for comprehensive and compassionate fistula care. Understanding how providers perceive and relate to their patients provides valuable insight to the unique challenges of treating this population and may better inform treatment programmes to address the gap between patient needs and current fistula care models.

Original languageEnglish (US)
Article number557224
JournalFrontiers in Global Women's Health
StatePublished - 2020
Externally publishedYes

Bibliographical note

Funding Information:
We would like to thank our partner organizations that made this research possible: the Worldwide Fistula Fund, Hamlin Fistula Ethiopia, Mekelle University College of Health and Sciences, and Healing Hands of Joy. Publication of this article in an open access journal was funded by the Portland State University Library's Open Access Fund. Funding. Funding for this study was provided by the Worldwide Fistula Fund.

Publisher Copyright:
Copyright © 2020 Jacobson, Marye, Phoutrides and Nardos.


  • Ethiopia
  • obstetric fistula
  • obstetrics & gynecology surgeries
  • qualitative analysis
  • urinary incontinence


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