Knowledge and associated factors of obstetric fistula among antenatal care attendees at Faji Kunda and Farafenni health facilities, The Gambia

Abstract

An obstetric fistula is an inappropriate communication between the vagina and surrounding tubular organs, usually, the rectum and bladder, resulting in leakage. The World Health Organisation estimates that 50,000–100,000 women worldwide suffer from obstetric fistula each year. In-country literature reveals Gambian women know little about obstetric fistula. No published data existed on antennal women’s perspectives and obstetric fistula knowledge factors. This study examines obstetric fistula knowledge and associated factors among antenatal care attendants at Faji Kunda and Farafenni Health Facilities, The Gambia. A facility analytical cross-sectional study included 385 antenatal care attendees. Study participants were recruited using systematic sampling. Statistical Package for the Social Science (SPSS) version 24 cleaned and stored the data, while Statistical Software Package (SATA) version 18 analysed it. Tables with percentages showed descriptive data. Parallel multivariate logistic regression and Chi-square were used to determine obstetric fistula knowledge factors. The significance level was p < 0.05 with a 95% CI. Most study participants (37.92%) were 18–23 years old, and 37.4% (n = 144) had no formal schooling. The study found that 24.2% (n = 93) of participants knew adequately about obstetric fistula. Results show a significant association (p < 0.001) between obstetric fistula knowledge and age. Results indicate a strong association (p < 0.001) between obstetric fistula knowledge and education levels. Higher chances are observed for tertiary education attendees [aOR=8.55; p < 0.001; 95% CI (2.83–25.81)]. Awareness of obstetric fistula was substantially linked to occupation, particularly among government personnel [aOR=18.6; p < 0.001; 95% CI (5.29–65.38)]. A higher connection was found among attendees from wealthy backgrounds [aOR=7.41; p < 0.001; 95% CI (2.40–22.84)]. The study participants knew little about obstetric fistulas. According to the study, age, education, income index, and occupation were significantly associated with obstetric fistula knowledge. Therefore, a widespread campaign to promote girls’ education and obstetric fistula awareness is needed.