Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso: A Cross-Sectional Study

Aduragbemi Banke-Thomas is a former Erasmus Mundus Europubhealth scholar at the University of Sheffield and École des Hautes Études en Santé Publique. He is currently working as a Research Assistant in the Centre for Maternal and Newborn Health at the Liverpool School of Tropical Medicine, where he is also conducting his doctoral studies, exploring the suitability of the innovative social return on investment methodology on accounting for impact of a maternal health intervention in low and middle income countries.He remains committed to networking and collaboration with other researchers within his area of interest - maternal and child health.

The title of Aduragbemi's research project was 'Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso: A Cross-Sectional Study'. Along with his co-authors,  Salam F. Kouraogo, Aboubacar Siribie, Henock B. Taddese and Judith E. Mueller, Aduragbemi has recently published his paper in PLoS ONE. 

Obstetric fistula is a sequela of complicated labour, which, if untreated, leaves women handicapped and socially excluded. In Burkina Faso, incidence of obstetric fistula is 6/10,000 cases amongst gynaecological patients, with more patients affected in rural areas. This study aims to evaluate knowledge on obstetric fistula among young women in a health district of Burkina Faso, comparing rural and urban communities. This cross-sectional study employed multi-stage sampling to include 121 women aged 18-20 years residing in urban and rural communities of Boromo health district. Descriptive statistics and multiple logistic regression analysis were used to compare differences between the groups and to identify predictors of observed knowledge levels. Rural women were more likely to be married (p<0.000) and had higher propensity to teenage pregnancy (p=0.006). The survey showed overall poor obstetric fistula awareness (36%). Rural residents were less likely to have adequate preventive knowledge than urban residents [OR=0.35 (95%-CI, 0.16–0.79)]. This effect was only slightly explained by lack of education [OR=0.41 (95%-CI, 0.18–0.93)] and only slightly underestimated due to previous pregnancy [OR=0.27 (95%-CI, 0.09–0.79)]. Media were the most popular source of awareness amongst urban young women in contrast to their rural counterparts (68% vs. 23%). Most rural young women became ‘aware’ through word-of-mouth (68% vs. 14%). All participants agreed that the hospital was safer for emergency obstetric care, but only 11.0% believed they could face pregnancy complications that would require emergency treatment. There is urgent need to increase emphasis on neglected health messages such as the risks of obstetric fistula. In this respect, obstetric fistula prevention programs need to be adapted to local contexts, whether urban or rural, and multi-sectoral efforts need to be exerted to maximise use of other sectoral resources and platforms, including existing routine health services and schools, to ensure sustainability of health literacy efforts.