Evidence map›Paper›PMID 41366452›Full record

ArticleReproductive health2025

I feel like an outcast!: qualitative exploration on barriers to seek care among women with obstetric fistula in Tigray, Northern Ethiopia.

Liya Mamo Weldu, Haben Haileselasie, Znabu Hadush Kahsay, Brhane Ayele, Tsegay Hadgu, Hailay Gebretnsae, Hayelom Kahsay, Ashenafi Asmelash, Tesfu Alemu, Melaku Abrha and 3 more

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Article in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Liya Mamo WelduSchool of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia. mliya6555@gmail.com.
Haben HaileselasieMARCH research center, College of Health Sciences, Mekelle, Tigray, Ethiopia.
Znabu Hadush KahsaySchool of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
Brhane AyeleTigray Health Research Institute, Mekelle, Tigray, Ethiopia.
Tsegay HadguTigray Health Research Institute, Mekelle, Tigray, Ethiopia.
Hailay GebretnsaeTigray Health Research Institute, Mekelle, Tigray, Ethiopia.
Hayelom KahsayTigray Health Research Institute, Mekelle, Tigray, Ethiopia.
Ashenafi AsmelashMums for Mums, Mekelle, Tigray, Ethiopia.
Tesfu AlemuUNFPA, Tigray filed office, Mekelle, Ethiopia.
Melaku AbrhaMekelle Hamlin Fistula center, Mekelle, Tigray region, Ethiopia.
Gebrehaweria GebrekurstoseTigray Health Bureau, Mekelle, Tigray, Ethiopia.
Mussie Alemayehu GeberselassieSchool of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
Araya Abrha MedhanyieSchool of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObstetric fistula, an abnormal opening between a woman's genital tract and her urinary tract or rectum. It's caused by prolonged, obstructed labor without access to timely, high-quality medical treatment. A significant number of women face barriers in accessing care, prompting this study to focus on the complicated obstacles hindering effective healthcare, and preventing timely diagnosis, treatment, and prevention.

objectivesThis study investigates the health-seeking behaviors and experiences of obstetric fistula survivors, spanning from the onset of the condition until surgical treatment is obtained. METHODOLOGY: A qualitative study design, drawing from a phenomenological approach, was employed to explore the lived experience of a purposively selected sample of eight women with obstetric fistula and six key informant interviews which are 5 Experts and 1 Fistula ambassador/ treated. Transcription was used, entered as primary documents into Atlas. ti 9 software. Thematic categories were identified.

resultsThe study identified barriers for health-care seeking and experiences of women with obstetric fistula, Women's experiences were marked by prolonged suffering, social isolation, and delayed healthcare-seeking. Many initially believed obstetric fistula was caused by spiritual punishment or witchcraft, leading them to seek help from traditional healers rather than medical facilities. Fear of shame, leaking urine, and social rejection discouraged public disclosure and prevented them from traveling to hospitals. Some women remained untreated for years due to lack of financial means or because male family members discouraged seeking help. However, survivors who accessed care typically did so with the encouragement of community health workers or NGOs, and often described the surgery as life-changing.

conclusionWomen suffering from obstetric fistula often face complicated routes to seek treatment due to multiple factors. Primary barriers include financial difficulties, lack of awareness about the condition and its treatment, social and cultural challenges, and war. To alleviate the prolonged suffering experienced by women awaiting fistula treatment, it is crucial to increase awareness and improve access to fistula treatment center.

Indexed as

Health Services AccessibilityObstetric Labor ComplicationsPatient Acceptance of Health CareVesicovaginal FistulaAdultEthiopiaFemaleHealth Knowledge, Attitudes, PracticeHumansPregnancyQualitative ResearchYoung AdultEthiopiaHealthcare barriersObstetric fistulaTigray

Identifiers

PMID41366452
PMCPMC12690963

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.