Obstetric fistula is abnormal passage way between the vagina and bladder or rectum may develop after prolonged and obstructed labor and lead to continuous urinary or fecal incontinence(1). Obstetric fistula can happen between the bladder and the vagina, between the rectum and vagina or both, leading to uncontrolled leakage of urine and/or feces(2).
The commonest type of obstetric fistula is Vesico-vaginal Fistula (VVF) which accounts 79% of cases but there are also cases of Recto Vaginal Fistula (RVF) 1-8% and combined (VVF and RVF) 1-23 %.Obstetrics fistula is related with numerous risk factors, and they appear to be escapable. This condition is related with young status at delivery, primi-parity, prolonged labor and home delivery(3).
In developed countries surgery and radiotherapy are the major risk factors for the situation, while obstetric complications are the main risk factors in developing nations, fistulas are also found in other parts of the world where fertility is high, the economic status of women is low, and obstetric services are poor, such as in Afghanistan, Pakistan, Bangladesh and parts of India (4).
Globally, around one million girls and women are currently suffering from obstetric fistula, Less than 20,000 women with obstetric fistula are treated each year. Obstetric fistula is a disease of poverty(5).Obstetric fistula occurs in all developing countries especially in the Northern half of Sub-Saharan Africa from Mauritania to Eritrea and in the developing countries of the Middle East and Asia(6).
Obstetric fistula prevention strategies classifies into primary prevention strategies (focused on contraception), secondary prevention strategies (ensuring women can access skilled care for delivery) and tertiary prevention strategies (early screening for fistula for most at risk women. Fistula is treatable as well as preventable. The success rates of obstetric fistula surgery in the literatures are between 70 to 90 per cent for simple fistulas, and between 30 and 60 per cent for complex or complicated cases. The world is standing by declaring May 23 as the International Day to end obstetric fistula and the decision to continue to use this Day each year to extensively raise knowledge and strengthen actions towards ending obstetric fistula(7).
Resolution adopted by the General Assembly on 25 September, 2015 (Sustainable Development Goal) states under Target 3.7: by 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs(8).
Obstetric fistula is a source of concern to medical practitioners in developing countries, awareness about it and the risk factors appear inadequate. There is need to appropriately inform women during their antenatal clinic visits about the risk factors for obstetric fistula and where to find care when faced with this challenge(9).
Obstetric fistula is considered to be the most worrying morbidity that affects women following childbirth. Medical consequences of fistula include incontinence, infection and possibly infertility. Social consequences of fistula are isolation, abandonment, disgrace and vulnerability(10).
Awareness is the ability to directly know and perceive, to feel, or to be heedful of events, More broadly, it is the state of being conscious of something(11).
Lack of awareness is a frequently mentioned barrier to seeking fistula treatment; many women who suffer from obstetric fistula do not know what fistula is, that their condition is treatable, or where to get treatment. Women with fistula and members of their community may also be misinformed about the causes of fistula, in some communities fistula is believed to be a curse or a punishment from God(12).
Occurrence of obstetric fistula is highly related with lack of awareness (misperception) on risk factors of obstetric fistula. Majority of respondents associated obstetric fistula directly with mistakes made by hospital personnel or problems during procedures other than other risk factors and this perception reduces health seeking behavior(13) .
Many of women are not aware of how to prevent obstetric fistula. If such women develop obstetric fistula during the process of childbirth it is also difficult for them to get treatment since they may not even be aware that it can be treated(10) .
Deficiency of knowledge on presentation of obstetric fistula hinders seeking treatment(14).
Even though obstetric fistula has likely weighed down women since the beginning of time, very little research proportionally exists. For obstetric fistula, there is a desperate need for rigorous and ethical research(15).