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Determinants of Recovery From Obstetric Fistula in Ethiopia: A Systematic Review and Meta-Analysis
Chalie Mulugeta1, Tadele Emagneneh1, Assefa Sisay2
1Department of Midwifery, College of Health Science, Woldia University, Weldiya, Ethiopia.
Aim:
This study aimed to assess the prevalence of recovery from obstetric fistula and identify factors associated with recovery amongst women in Ethiopia.
Design:
A systematic review and meta-analysis of retrospective cohort studies were conducted.
Methods:
A comprehensive search was performed in PubMed, Google Scholar, EMBASE, Cochrane Library and Hinari using relevant keywords and Boolean operators. In addition, grey literature sources such as Google Scholar, institutional repositories and reports from international organisations. Data extraction was done using Microsoft Excel, and statistical analyses were conducted in Stata version 11. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated with a funnel plot and Egger's test, and heterogeneity was measured using the I-squared statistic.
Results:
Ten studies including 2382 participants from four regions of Ethiopia, were analysed. The pooled prevalence of recovery from obstetric fistula was 80.42% (95% CI: 75.74-85.10). Factors significantly associated with recovery included: maternal height ≤ 150 cm (AHR: 1.30; 95% CI: 1.14-1.47; I2 = 83.5%), antenatal care attendance (AHR: 1.30; 95% CI: 1.08-1.52; I2 = 96.8%), institutional delivery (AHR: 1.40; 95% CI: 1.12-1.70; I2 = 97.3%), duration of incontinence < 3 months (AHR: 1.41; 95% CI: 1.11-1.71), intact urethra (AHR: 2.27; 95% CI: 1.39-3.14; I2 = 99.3%), vaginal delivery (AHR: 1.69; 95% CI: 1.10-2.28; I2 = 99.1%) and fistula width ≤ 2 cm (AHR: 1.43; 95% CI: 1.05-1.81; I2 = 97%).
No Patient Or Public Contribution:
This study was based on previously published studies, and no direct patient or public involvement was included.
Conclusion:
Recovery from obstetric fistula in Ethiopia remains suboptimal. Factors significantly associated with better recovery outcomes included maternal height, antenatal care attendance, institutional delivery, mode of delivery, duration of incontinence ≤ 3 months, intact urethra and fistula width ≤ 2 cm. Targeted interventions focusing on these factors-such as increasing antenatal care uptake, promoting institutional deliveries and ensuring early management of incontinence-are essential to improve recovery outcomes for affected women.
Trial Registration:
PROSPERO: CRD420261422331.