Outcomes of Two Different Obstetric Social Reintegration Program Approaches After Obstetric-Related Fistula Repair

Area of Science:

• Public Health
• Surgical Outcomes
• Women's Health

Background:

• Obstetric-related vesicovaginal fistula (VVF) significantly impacts women's psychosocial and economic well-being.
• Comprehensive reintegration services are crucial for post-repair recovery and societal re-integration.
• Comparing dedicated fistula centers with general hospitals is essential for optimizing care models.

Purpose of the Study:

• To compare psychosocial-economic outcomes after VVF repair (OFR) and reintegration services.
• To evaluate the effectiveness of a dedicated fistula center (ARENA) versus a multispecialty hospital (LEMC).

Main Methods:

• Retrospective study of women undergoing OFR and reintegration training.
• Data collected via standardized questionnaires on psychosocial and economic factors.
• Statistical analyses included Wilcoxon rank sum, Chi-squared, Fisher's exact tests, and logistic regression.

Main Results:

• No significant differences in median age or time living with fistula between centers.
• Women treated at the dedicated fistula center had higher odds of self-satisfaction (aOR 4.6).
• Women at the dedicated center reported greater feelings of worth (aOR 12.6) and income-generating assets (aOR 5.1).

Conclusions:

• Dedicated fistula centers provide superior psychosocial and economic outcomes post-OFR.
• Specialized care and reintegration services at dedicated centers significantly improve women's lives.
• These findings support the model of specialized fistula centers for comprehensive patient recovery.