Determinants of return for review in recommended time after repair among obstetric fistula patients: a case study of Kitovu Hospital, Masaka Uganda

Abstract

Although there is an increasing body of literature emerging on fistula and its impact on society, many of the reviewed studies scarcely discuss subsequent practices after fistula repair. Fistula treatment through surgery is reported to be successful in 80–90% of cases. Despite the high success rate after repair, clients are likely to develop severe post-operative complications including stress incontinence. This study, therefore, aimed to better understanding the post-discharge practices and care after fistula surgery. This was a cross-sectional study based on 130 women who had returned for review at Kitovu Hospital. Data were analyzed at three different levels; the Univariate level using a descriptive summary was performed to show the distribution of each variable in the study. At the Bivariate level, a Pearson Chi-square test was deemed significant if the p-value was less or equal to 0.05. At the Multivariable stage, determinants of return for review to hospital status were assessed using a Logistic Regression, given the dichotomous nature of the study outcome (return for review). This study found that married women were more likely to return for review after the surgical operation as advised (OR=15.7; P = 0.008). The odds of return for review were high among women who had secondary education (17.7; P = 0.019), women who were employed (OR=8.11; P = 0.014), and among women who practiced pelvic floor exercises (OR=3.36; P = 0.046) when compared to their counterparts that had fewer muscle exercises. Further, results indicated that the more children the woman had the less likelihood of them to return to the facility on time as recommended by doctors (OR=0.27; P = 0.047) when compared to those with no children ever born. Attention to improving access and return for review for fistula patients in fistula facilities should focus on improved time availability for women and efforts to improve their social-economic status.