Assessment of Awareness on Vesico-Vaginal Fistula among Women of Reproductive Age in Kawangware Slums, Nairobi City County, Kenya
Maeri, Jacquelyne Aluoch
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Obstetric Vesico-Vaginal Fistula is a reproductive health problem mainly caused by prolonged obstructed labour and delay in seeking emergency obstetric care after delivery. In developing countries such as those in sub-Saharan Africa, obstetric Vesico-Vaginal Fistula continues to cause suffering to a number of women and their families. Women with obstetric fistula not only have to endure the negative physical and emotional impacts of the disease but also social and economic impacts which are also negative. Considering the suffering of families associated with this disease, we set out to investigate community awareness of obstetric fistula especially in areas with poor access to social amenities such as informal settlements. The main aim of this study was to assess the level of community awareness among women of reproductive age in Kawangware Slums of Nairobi City County, Kenya. The study mainly focused on community awareness, knowledge levels, risk factors and attitudes towards Vesico-Vaginal Fistula. The study used descriptive cross-sectional study design. Both quantitative and qualitative data were collected. Quantitative data was collected using questionnaires administered to women of reproductive age while qualitative data was collected using focused group discussion guides. The study targeted 422 adult women aged 18 years and above in Kawangware slums. Systematic random sampling was used to select respondents using a predetermined interval. Every fifth woman who met the inclusion criteria was included in the study. The researcher obtained ethical clearance from the Kenyatta University Ethical Review Committee prior to data collection and a research permit from National Commission for Science, Technology and Innovation. Informed consent was also sought from study respondents. Data was then cleaned and entered into a Microsoft excel datasheet for processing. This was later exported to SPSS version 22.0 for analysis. Descriptive data were presented using frequency tables, graphs and pie-charts. Inferential statistics were done to establish the relationship between variables using Chi-square tests done at 95% confidence interval and p-values of <0.005 considered statistically significant. Qualitative data from focused grouped discussions were triangulated with quantitative data as direct quotes or narrations from respondents. The results revealed that 56% of respondents had low awareness with scores of less than 5. 57% of respondents had low knowledge on occurrence of VVF. Knowledge levels were significantly associated with community awareness (p=0.004). Majority of risk factors were significantly associated with community awareness such as early pregnancy (p=0.001), delayed access to obstetric care (p=0.006) and prolonged labour. 67% of respondents had negative attitude towards Vesico-vaginal Fistula based on Likert scale scores. There were significant statistical association between attitude and community awareness (p=0.010). The study concludes that the respondents from Kawangware had low awareness levels, low knowledge levels and negative attitude towards Vesico-Vaginal Fistula. The findings will be availed to governmental and non-governmental organizations for structuring programs and strategizing on interventions targeting creation of community awareness as well as its prevention and management. These results would also be of use to the Ministry of Health for purposes of health education, policy formulation and implementation with regards to workable short and long-term Vesico-Vaginal Fistula interventions.