Coping with a Disruptive Life Caused by Obstetric Fistula: Perspectives from Malawian Women

Josephine Changole, Viva Thorsen, Jone Trovik, Ursula Kafulafula and Johanne Sundby
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Josephine Changole: Department of Community Medicine and Global Health, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway
Viva Thorsen: Department of Community Medicine and Global Health, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway
Jone Trovik: Department of Clinical Science, University of Bergen, P.O. Box 7804, 5021 Bergen, Norway
Ursula Kafulafula: Department of Obstetrics and Gynecology, Haukeland University Hospital, National Treatment Center for Gynecological Fistula, P.O Box 1400, 5021 Bergen, Norway
Johanne Sundby: Department of Community Medicine and Global Health, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway

IJERPH, 2019, vol. 16, issue 17, 1-14

Abstract: Background : The main symptom of obstetric fistula is urinary and or fecal incontinence. Incontinence, regardless of the type is debilitating, socially isolating, and psychologically depressing. The objective of this study was to explore the strategies that women with obstetric fistula in Malawi use to manage it and its complications. Methods : A subset of data from a study on experiences of living with obstetric fistula in Malawi was used to thematically analyze the strategies used by women to cope with their fistula and its complications. The data were collected using semi-structured interviews. Nvivo 10 was used to manage data. Results : Participants used two forms of coping strategies: (1) problem-based coping strategies: restricting fluid intake, avoiding sexual intercourse, using homemade pads, sand, corn flour, a cloth wreathe and herbs, and (2) emotional-based coping strategies: support from their families, children, and through their faith in God. Conclusion : Women living with incontinence due to obstetric fistula employ different strategies of coping, some of which conflict with the advice of good bladder management. Therefore, these women need more information on how best they can self-manage their condition to ensure physical and emotional comfort.

Keywords: fistula; incontinence; Malawi; Bwaila; coping; concealing; problem-focused; emotional (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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