Knowledge of obstetric fistula and contributing factors among reproductive-age women in Ethiopia: a systematic review and meta-analysis

Introduction

Obstetric fistulas are one of the most severe injuries resulting from prolonged, obstructed labor, particularly when timely medical care is unavailable. In Ethiopia, numerous women and girls continue to endure the consequences of obstetric fistula due to contributing factors like early marriage and limited access to skilled healthcare during childbirth. The development of prevention strategies remains challenging, as reports on the knowledge surrounding obstetric fistulas and their causes are inconsistent across the country. To assess the overall, knowledge of reproductive-aged women regarding obstetric fistulas and the contributing factors to its occurrence.

Methods

Studies were systematically searched from May 30 2024 to July 1, 2024, using Web of Science, Scopus, PubMed/Medline, Science Direct, African Journal Online, and the Wiley Online Library. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effects meta-analysis was performed with STATA version 11 software to estimate the knowledge, and the results are reported in a forest plot. Simple charts and tables were used to summarize the evidence for the pooled level of knowledge and its determinants.

Results

The pooled knowledge of fistula complications among reproductive-aged women in Ethiopia was 43.3% (95% CI: 35.2, 51.4). Above secondary education level (OR=3.73[2.40, 5.86]), urban residence (OR=3.77 [2.45, 5.80], access to media (OR=2, 82[1.26, 6.33]), and women attended pregnancy conference (OR=3.75[2.35, 5.99]) were determinants of good knowledge of obstetric fistula.

Conclusions

In Ethiopia, only 43.3% of reproductive-age women had good knowledge about obstetric fistulas. Factors that contribute to a higher knowledge include having a secondary education, living in urban areas, access to media, and attending pregnancy-related conferences. To improve knowledge, it is recommended to increase specific education on obstetric fistulas and prevention strategies, particularly for women living in rural areas. Promoting institutional deliveries and providing better health education on how to prevent obstetric fistulas, including pregnancy conferences is essential. Additionally, policymakers and stakeholders should focus on empowering women of reproductive age and addressing the overlooked yet significant public health issue of obstetric fistulas.