Article,
Re-Integrating Fistula-Repaired Women into Society in Central Uganda: A Community Participatory and Action Approach
Advances in Preventive Medicine and Health Care (ISSN: 2688-996X), 6 (2): 2 (August 2021)
Abstract
Introduction: Women with repaired Obstetric Fistula (OF) are often socially isolated, discriminated and stigmatized. Consequently, they may require support to reintegrate them into communities. We designed and implemented a pilot intervention
to integrate women with repaired OF in two districts (Kiboga and Kyankwanzi) in Uganda. Methodology: Prior to the design of the intervention, one hundred key informants were interviewed. Data was collected on the probable local solutions/actions that could be undertaken to reintegrate women with repaired OF and the challenges they would face in getting reintegrated into the community. These findings were used to inform the design of the pilot intervention using a community participatory reflection approach (PRA) model encompassing five steps: 1) Raising community awareness; 2) identification of neighbors of the women with repaired OF; 3) development of an action plan with full participation of the community; 4) implementation of agreed actions; and 5) monitoring and evaluation. Results: Baseline findings from the 100 people interviewed revealed that women with OF were afraid of people and in hiding, they were silent about their condition, they smelled badly and were shunned by others, people were unfriendly to them, and they were sad and uncooperative. Eight women were identified with unrepaired OF and referred to health facilities. Community members visited the families of women with OF and made contributions of basic needs. Community members also encouraged women with OF women to join social groups to uplift their standard of living. The women with OF were encouraged to become advocates for the campaign to end fistula. The free discussions enabled women with OF to speak boldly about their condition
which contributed to the reduction of stigma against them. Subsequently 30 more women with OF were identified. The end-line was that their participation and social inclusion in community functions increased, significant stigma mitigation was achieved,
poverty reduction was noticed as they resumed income generating work, and the women were accorded equal opportunity in society like everybody else.
Discussion: Communities were virtually ignorant of the challenges faced by women with OF but were willing to help once sensitized. Women with OF, when well informed, opened up to the community members. The community responded positively
by visiting them and providing them with some basic needs. Through all these actions, women with OF were empowered enough to be included into community groups and programs. Conclusion: The social impact of OF on women can be effectively mitigated by the combined actions on and by the community and OF women sufferers themselves. The awareness raising and comprehensive approach could lead to fistula prevention and pave way for the treatment of OF when they still occur.
