Factors associated with obstetric fistula among reproductive age women in Ethiopia: a community based case control study

Plain language summaryGlobally, 2-3 million women are affected by obstetric fistula. It is common in developing nations, mainly in sub-Saharan Africa and Southeast Asia where suitable, timely care and treatment are hard to find. This devastating condition adversely affects women's physical and mental health. There is little research conducted in relation to the experiences of women living with leakage of urine and/or feces in Ethiopia. Therefore, this study provides a better understanding on obstetric fistula and its associated factors.The present study used the recent Ethiopia Demographic Health Survey (EDHS) 2016, to determine the associated factors of obstetric fistula among reproductive age group women (15-49 years) in Ethiopia.In this study rural residence, poorest wealth index, age at first marriage less than 18 years, and decision making for contraceptive use by husband alone were the associated factors of obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels. Comprehensive intervention strategies should be customized at different government hierarchies to combat and reduce obstetric fistula. BackgroundObstetric fistula is a major public health concerns in Ethiopia. It is the most devastating cause of all maternal morbidities.MethodData from the 2016 Ethiopian Demographic Health Survey (EDHS) was analyzed. A community-based unmatched case control study was conducted. Seventy cases and 210 non cases were selected using random number table. Data were analyzed by using STATA statistical software version 14. Multivariable logistic regression model was applied to determine the factors associated with fistula.ResultsThe majority of fistula cases were from rural residences. The multivariable statistical model showed that rural residence (Adjusted OR (AOR) = 5, 95% CI 4.26, 7.52), age at first marriage (AOR = 3.3, 95% CI 2.83, 4.60), poorest wealth index (AOR = 3.3, 95% CI 2.24, 5.01) and decision making for contraceptive use by husband alone (AOR = 1.3, 95% CI 1.124, 1.67) were factors significantly associated with obstetric fistula.ConclusionAge at first marriage, rural residence, poorest wealth index and decision making for contraceptive use by husband alone were significantly associated factors for obstetric fistula. Intervening on these factors will reduce the magnitude of obstetrics fistula. In this context there is in-need to improve on avoiding early marriage through awareness creation to the community and developing legal framework by the policymakers. Furthermore, information about the joint decision making to use contraceptives should be disseminated though mass-media and interpersonal channels.