Obstetric fistula and related factors: assessing pattern and quality of life among women in Southwest Nigeria


  • Adebukunola O. Afolabi Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Mary T. Bifarin Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Gladys O. Oluwasanmi Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Munirat O. Oladokun Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Helen F. Fatoke Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Abigail A. Abioye Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
  • Lauretta S. Daramola Clinical Nursing Services, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria




Obstetric fistula, Quality of life, Women , Nigeria


Background: Obstetric fistula remains major contributor to maternal morbidity in low resource countries. Study examined quality of life and related factors among women with obstetric fistula in Southwest Nigeria.

Methods: A cross-sectional study, involving 159 purposively selected women receiving care at the fistula centre, Wesley Guild Hospital, Ilesa, Southwest Nigeria. An adopted interviewer-administered World Health Organization Quality of Life Scale, WHOQOL-BREF was employed to examine quality of life. Data was processed and analyzed using IBM statistical product and service solutions (SPSS) software version 25. Analysis was done at univariate, bivariate and multivariate levels. Fisher’s exact, Analysis of Variance, Independent t-test and Regression analysis examined association and significance, p<0.05.

Results: Findings shows that 64.20% of the women had vesicovaginal fistula, 17.60% had rectovaginal fistula, 10.70% had uterovaginal fistula while 7.5% had ureterovaginal fistula. The mean scores for physical, psychological, social relationship and environmental health domains were 48.92 ±14.89, 39.91±17.42, 68.71±30.85, 42.75±18.60 respectively. Overall quality of life had mean score of 19.89 ±26.51 while 82.4% of the women had low quality of life, 2.5% had moderate and 15.1% had high quality of life overall. Regression analysis shows significant association between low quality of life and primipara (p=0.002, RRR=32.55, CI=3.73-284.19), multipara (p<0.001, RRR=23.20, CI=5.12-105.13), middle socio-economic status (p=0.02, RRR=4.62, CI=1.29-16.59).

Conclusions: Significant proportion of the women studied had low quality of life. Parity and socio-economic status were main predictors of quality of life. Holistic management of obstetric fistula should take cognizance of these variables for optimal outcomes.


Bello O, Morhason-Bello I, Ojengbede O. Nigeria, a high burden state of obstetric fistula: a contextual analysis of key drivers. PanAfrican Med J. 2020;36:1-12.

Yismaw L, Alemu K, Addis A, Alene M. Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia. BMC Womens Health. 2019; 19(5):1-8.

United Nation Population Fund, UNFPA 2022. https://unfpa.org/. Accessed on 20 November 2022.

World Health Organization W. Available at: https://www.who.int. Accessed on 20 November 2022.

Quedraogo I, Payne C, Nardos R, Adelman A, Wall L. Obstetric fistula in Niger: 6 month postoperative follow-up of 384 patients from the Danja Fistula Center. Int Urogynecol J. 2018;29:345-351.

Aynalem G, Kassie B, Baye C. Long-term effects of obstetric fistula on the overall quality of life among survivors who had undergone obstetric fistula repair, Central Gondar zone, Northwest Ethiopia, 2020: A community-based study. Rehabil Res Pract. Published online 2022:1-13.

Matiwos B, Tesfaw G, Belete A, Angaw D, Shumet S. Quality of life and associated factors among women with obstetric fistula in Ethiopia. BMC Womens Health. 2021;21(321):1-17. Ahmed S, Curtis S, Jamil K, et al. Obstetric fistula in Bangladesh: Estimates from a national survey with clinical validation correction. Lancet Glob Heal. 2022;10(9):5-6.

Nigeria National Population Commission N. Nigeria Demographic and Health Survey, NDHS.; 2018. doi:https://dhsprogram.com/pubs/pdf/PR118/PR118.pdf

Maheu-giroux M, Filippi V, Samadoulougou S. Prevalence of symptoms of vaginal fi stula in 19 sub-Saharan Africa countries: a meta-analysis of national household. Lancet Glob Heal. 2015;3:e271-8.

Nigeria Federal Ministry of Health Fm. Available at: https//www.nbs.gov.sc. Accessed on 20 November 2022.

Bashah D, Worku A, Mengistu M. Consequences of obstetric fistula in sub Sahara African countries, from patients ’ perspective: a systematic review of qualitative studies. BMC Wo. 2018;18(106):1-12.

Mselle L, Kohi T. Living with constant leaking of urine and odour: thematic analysis of socio-cultural experiences of women affected by obstetric fistula in rural Tanzania. BMC Womens Health. 2015;15(107): 1-9.

Gondwe M, Maharaj P. Factors that impact the timely treatment of obstetric fistulas in Malawi: The perspective of health care providers. Afr J Prm Heal Care Fam Med. 2019;

Tebeu P, Fomulu J, Khaddaj S, Bernis D, Delvaux T, Rochat C. Risk factors for obstetric fistula: A clinical review. Int Urogynecol J. 2012;23:387-94.

Ngongo C, Raassen TIP, Mahendeka M, Lombard L, Roosmalen J, Temmerman M. Rare causes of genital fistula in nine African countries: a retrospective review. BMC Womens Health. 2022;22(497):1-5.

Amodu O, Salami B, Richter M. Obstetric fistula policy in Nigeria : a critical discourse analysis. BMC Preg Childbirth. 2018;18(269):1-9.

Bellows B, Bach R, Baker Z, Warren C. Barriers to Obstetric Fistula Treatment in Low-Income Countries: A Systematic Review.; 2014.

Okoye U, Emma-Echiegu N, Tanyi P. Living with vesico-vaginal fistula : experiences of women awaiting repairs in Ebonyi State, Nigeria. Tanzan J Heal Res. 2014;16(4):322-8.

Braveman P, Gottlieb L. The social determinants of health: It’s time to consider the causes of the causes. Public Heal Rep. 2014;129(2):19-31.

Wingen T, Englich B, Estal-Munoz V, Silvana M, Kassianos A. Exploring the relationship between social class and quality of life: the mediatingj. Tanzan J Heal Res. 2012;14(2):103-8.

Ruggeri K, Garcia-garzon E, Maguire A, Matz S, Huppert F. Well-being is more than happiness and life satisfaction: a multidimensional analysis of 21 countries. Heal Qual Life Outcomes. 2020;18(1):5-6.

Debela T, Hordofa Z, Aregawi A, Sori D. Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia. BMC Womens Health. 2021;21(212):1-8.

Kakembo S, Atuhairwe C, Taremwa I. Quality of Life among Obstetric Fistula Patients at Kitovu Mission Hospital : A Health Facility-Based Cross-Sectional Study in Masaka District , Uganda. Obstet Gynecol Int.

World Health Organization W. WHOQOL User Manual.; 2012. Available at: https://www.who.int/ tools/whoqol. Accessed on 20 November 2022.

WHOQOL-BREF: Introduction, Administation, Scoring and generic version of the assesment. Published online 1996. https://apps.who.int/iris/ handle/10665/63529. Accessed on 20 November 2022.

Gholami A, Jahromi L, Zarei E, Dehghan A. Application of WHOQO‑BREF in Measuring Quality of Life in Health‑Care Staff. Int J Prev Med. 2013;4: 809-17.

Hadning I, Ainii N. An Analysis of Health Workers’ Quality of Life in Indonesia During COVID-19 Pandemic. Adv Heal Sci Res. 2021;33:425-30.

Hurissa B, Koricha Z, Dadi L. Quality of life and its predictive factors among women with obstetric fistula in Ethiopia: A cross-sectional study. Front Public Heal. Published online 2022.

Daniyan A, Obuna J, Yakubu E, Ekwedigwe K, Shaagee A, Sunday-Adeoye I. Comparison of patterns of obstetric fistula between two periods in South-East Nigeria. Obstet Gynecol Int J. 2022;13(5):300-3.

Kuppusmamy R. Modified Kuppuswamy Scale: Socio-Economis Status. Adv Heal Sci Res. 2005;15:723.






Original Research Articles