Interventions for treating obstetric fistula: An evidence gap map

Area of Science:

• Medical Research
• Public Health
• Evidence Synthesis

Background:

• Obstetric fistula affects 50,000-100,000 women annually in low- and middle-income countries.
• The World Health Organization aims to eliminate obstetric fistula by 2030.
• Current evidence on obstetric fistula treatments is not well-understood, hindering progress.

Purpose of the Study:

• To map existing evidence on obstetric fistula treatments.
• To identify knowledge gaps in current research.
• To inform future research directions for obstetric fistula interventions.

Main Methods:

• An evidence map was created using data from systematic reviews, RCTs, cohort, and case-control studies.
• Searches were conducted across multiple databases (MEDLINE, Embase, CENTRAL, etc.) up to February 2022.
• A survey of stakeholders informed the evidence map framework and outcome measure relevance.

Main Results:

• 28 studies were included in the evidence map, with many showing some risk of bias.
• Most studies (71%) focused solely on surgical interventions for obstetric fistula.
• Limited data exists on quality of life, sexual function, and faecal incontinence outcomes.

Conclusions:

• There is a lack of robust evidence to guide optimal obstetric fistula treatment selection.
• Significant research gaps exist, particularly for non-surgical interventions and comprehensive outcome reporting.
• Further research is crucial to address evidence deficits and support global efforts to eradicate obstetric fistula.