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Social support for women after fistula repair: a scoping review

Kondwani Wella, Evelyn Chilemba, Annie Namathanga, Bertha Chakhame

Abstract

Background Obstetric fistula (OF) is a birth complication that largely affects women in developing countries. The women suffer constant incontinence, shame, social segregation, and health problems. Reconstructive surgery can usually repair OF, and enable women to reintegrate back into their communities. However, physically repair does not necessarily result in emotional recovery. Our objective was to explore women’s experiences of social support during the twelve months following a first time OF repair.

Methods An evidence synthesis was performed based on a systematic search of literature published between 2008 and October 2019 in PubMed, Medline and CINAHL databases using keywords “Obstetric Fistula”, "vesicovaginal fistula", "vesicovaginal", “Fistula”, and “Social Support”. Inclusion criteria were primary peer reviewed articles addressing one or more study objectives, in English, on OF support, regardless of location. Two reviewers independently assessed eligibility of the studies and extracted the data. Disagreement between the reviewers were resolved by a third reviewer.

Results The search resulted in 212 articles, of which 15 were included in this review. The analysis of the studies was guided by Berkman’s Model. The model suggests that there is a link between social resources, social support and disease. We found that support was either internal or external. Internal support constituted self-efficacy resulting into strengthened internal locus of control. Externally, women were supported by friends and family with material and financial resources. They were also supported with education opportunities, and business start-up capital. Our review also identified the need to support women with information about OF. Most women who were successfully integrated into their communities supported other women suffering from OF.

Conclusions Social networks make a significant contribution to emotional and psychological recovery of women after a successful OF surgical repair. Social networks were also found to be detrimental to emotional and psychological recovery of women. Most women were abandoned and not supported by their husbands. Only constructive surgery is not enough as OF treatment. Women need supportive and well organised social networks for them to make full recovery after OF repair.

Keywords
Obstetric fistula, Social support, social networks, Berkman’s model

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Preprint: Please note that this article has not completed peer review.

Social support for women after fistula repair: a scoping review

Kondwani Wella, Evelyn Chilemba, Annie Namathanga, Bertha Chakhame

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Abstract

Background Obstetric fistula (OF) is a birth complication that largely affects women in developing countries. The women suffer constant incontinence, shame, social segregation, and health problems. Reconstructive surgery can usually repair OF, and enable women to reintegrate back into their communities. However, physically repair does not necessarily result in emotional recovery. Our objective was to explore women’s experiences of social support during the twelve months following a first time OF repair.

Methods An evidence synthesis was performed based on a systematic search of literature published between 2008 and October 2019 in PubMed, Medline and CINAHL databases using keywords “Obstetric Fistula”, "vesicovaginal fistula", "vesicovaginal", “Fistula”, and “Social Support”. Inclusion criteria were primary peer reviewed articles addressing one or more study objectives, in English, on OF support, regardless of location. Two reviewers independently assessed eligibility of the studies and extracted the data. Disagreement between the reviewers were resolved by a third reviewer.

Results The search resulted in 212 articles, of which 15 were included in this review. The analysis of the studies was guided by Berkman’s Model. The model suggests that there is a link between social resources, social support and disease. We found that support was either internal or external. Internal support constituted self-efficacy resulting into strengthened internal locus of control. Externally, women were supported by friends and family with material and financial resources. They were also supported with education opportunities, and business start-up capital. Our review also identified the need to support women with information about OF. Most women who were successfully integrated into their communities supported other women suffering from OF.

Conclusions Social networks make a significant contribution to emotional and psychological recovery of women after a successful OF surgical repair. Social networks were also found to be detrimental to emotional and psychological recovery of women. Most women were abandoned and not supported by their husbands. Only constructive surgery is not enough as OF treatment. Women need supportive and well organised social networks for them to make full recovery after OF repair.

Figures

Background

Methods

Results

Discussion

Conclusions

Abbreviations

Declarations

References

Tables

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