Publication:

Prevalence and risk factors associated with obstetric fistula among women of reproductive age in Bungoma, Kilifi and Kiambu Counties, Kenya

Background Female genital fistula (FGF) is a debilitating childbirth-related condition affecting an estimated 50,000-100,000 women globally each year. In Kenya, the incidence is estimated at 17.4 cases per 100,000 deliveries, yet only about 8% of new cases receive surgical treatment annually. This study explored the risk factors, psychosocial experiences, healthcare-seeking behaviour, and coping mechanisms among women living with FGF in Bungoma, Kiambu, and Kilifi counties.

Methods A cross-sectional study was conducted among 113 purposively selected female genital fistula survivors. Quantitative data were collected using structured interviewer-administered questionnaires and analysed using descriptive statistics.

Results Severe depression was reported by 66.2% of participants, while 51.3% experienced anxiety associated with stigma and social exclusion. Suicidal thoughts were reported by 22.1% of respondents. Regarding childbirth, 59.3% delivered their youngest child in a health facility, whereas 40.7% delivered at home. Among home deliveries, the leading reason was the long distance to a health facility (40.0%). Social isolation was the most common coping strategy, reported by 59.3% of participants.

Conclusions Female genital fistula continues to have profound psychosocial consequences and remains closely linked to barriers in accessing skilled maternal healthcare. Strengthening maternal health services, promoting community awareness, and providing comprehensive post-repair care that integrates psychosocial and economic support are essential. Increased county investment in fistula prevention, treatment, rehabilitation, and reintegration programmes is recommended.