Midwives’ Knowledge and Use of Decision-making Tools for Prevention of Obstetric-fistula among Pregnant Women in Abuja General Hospitals
Eleanor Chinwe Nwaka *
African Centre of Excellence for Public Health and Toxicological Research, University of Port Harcourt, Choba, Rivers State, Nigeria.
Mina Longjohn
African Centre of Excellence for Public Health and Toxicological Research, University of Port Harcourt, Choba, Rivers State, Nigeria.
Emmanuel Oranu
African Centre of Excellence for Public Health and Toxicological Research, University of Port Harcourt, Choba, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Obstetric fistula, an improper connection between the genital tract and urinary or digestive tract, poses a significant public health concern, especially in sub-Saharan Africa and Southeast Asia.
This study aimed to assess midwives' knowledge and use of clinical decision-making tools for preventing obstetric-fistula among pregnant women within general hospitals in FCT Abuja, Nigeria. Conducted through a descriptive cross-sectional research design, the study employed a stratified random sampling technique, dividing Abuja into six strata representing Area Councils. One general hospital was randomly selected from each stratum by simple random technique. All 132 midwives working in the Maternal Health Service Units of the selected hospitals participated. Data collection utilized a self-structured questionnaire with multiple-choice questions and a 4-point Likert scale, exhibiting high reliability (Cronbach's alpha = 0.732). Statistical analysis employed SPSS version 26, analyzing demographic information through frequency and percentages. Research questions were addressed using mean ratings and confidence intervals, while hypotheses were tested using Chi-Square and Pearson Product Moment Correlation at a significance level of 0.05. Midwives demonstrated a high level of proficiency in utilizing established guidelines and best practices for preventing obstetric-fistula across prenatal, intrapartum, and postpartum periods (grand mean: 3.55 at 95% confidence level), as well as in employing clinical decision-making tools for prevention of obstetric fistula (grand mean: 3.65 at 95% confidence level). In conclusion, midwives in Abuja exhibit high proficiency in the use of clinical decision-making tools for prevention of obstetric fistula. To further enhance their competency, continuous training and sustainability efforts are recommended.
Keywords: Midwives, decision-making tools, obstetric-fistula
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References
Hareru HE, Wtsadik DS, Ashenafi E, Debela BG, Lerango TL, Ewunie TM, Abebe M. Variability and awareness of obstetric fistula among women of reproductive age in sub-Saharan African countries: A systematic review and meta-analysis. National Library of Medicine. Heliyon. 2023;9(8):e18126. 3 – 4. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407677.
UNFPA. 5 Things You Might Not Know About Obstetric Fistula; 2022. Available:https://arabstates.unfpa.org/en/news/5-things-you-might-not-know-about-obstetric-fistula-0
International Federation of Gynecology and Obstetrics (FIGO). FIGO Fistula Surgery Training Manual: A standardised training curriculum and guide to current best practice. London. 1- 8. Full final covered compress.pdf. www.figo.org; 2022.
Bello OO, Morhason-Bello IO, Ojengbede OA. Nigeria, a high burden state of obstetric fistula: A contextual analysis of key drivers. Pan African Medical Journal. 2020;36(1). Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388624/
Federal Ministry of Health, Nigeria. Guidelines on Urethral Catheterization for Prevention and Management of Obstetric Fistula in Nigeria. Nigeria; 2016.
Federal Ministry of Health, Nigeria. National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria, 2019 – 2023; 2019.
Amodu OC, Salami BO, Richter MS. Obstetric fistula policy in Nigeria: A critical discourse analysis. BMC pregnancy and childbirth. 2018;18:1-9.
Bulndi LB, Ireson D, Adama E, Bayes S. Women’s views on obstetric fistula risk factors and prevention in north-central Nigeria: An interpretive descriptive study. BMJ Open. 2023;13(6):e066923. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277036/
Mwogosi A, Kibusi S, Shao D. Tools and techniques for decision making in healthcare facilities in Tanzania: Usage, Challenges and resolutions. Journal of Health Informatics in Developing Countries. 2022;16(1). Retrieved from
Available:https://www.jhidc.org/index.php/jhidc/article/view/351
Alemu SS, Agago MT, Ukumo EY, Hadero TS. Knowledge and practice of obstetric care providers on prevention of obstetric fistula 2023: An institution-based cross-sectional study. Front. Glob. Womens Health. 2023;4:1234013.
DOI:10.3389/fgwh.2023.1234013.
Markos M, Arba A, Paulos K. Partograph utilization and associated factors among obstetric care providers working in public health facilities of Wolaita Zone, 2017. Journal of Pregnancy. 2020;3631808.
Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350161/
Mukisa J, Grant I, Magala J, Ssemata AS, Lumala PZ, Byamugisha J. Level of Partograph completion and healthcare workers’ perspectives on its use in Mulago National Referral and teaching hospital, Kampala, Uganda. BMC Health Services Research. 2019;(19)107. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367740/
Amodu OC, Salami B, Richter S. Obstetric fistula and sociocultural practices in Hausa community of Northern Nigeria. Women and Birth. 2017;(30)5: E258-e263.
Bulndi LB, Ireson D, Adama E, Bayes S. Sub-Saharan African women’s views and experiences of risk factors for obstetric fistula: A qualitative systematic review. BMC Pregnancy and Childbirth. 2022; 22(1):680.
UNFPA. Obstetric Fistula: Guiding Principles for Clinical Management and Programme Development. UNFPA. New York; 2020.