Ibadan Journal of the Social Sciences
Volume 23, No. 2, 2025
DOI: 10.36108/ijss/5202.32.0250
‘Leaking Women’ and the Weight of Ignorance on Maternal Health: Understanding the Sociocultural Determinants of Obstetric Fistula in Ebonyi and Plateau States, Nigeria
Okwuchi Chioma Efam1 and Ezebunwa E. Nwokocha2
1Department of Sociology, University of Jos, Plateau State, Nigeria
2Department of Sociology, University of Ibadan, Ibadan, Nigeria
Abstract
Obstetric fistula or vesicovaginal fistula (VVF), an uncontrollable and continuous leakage of urine from the vagina, is a major public health problem among young women in sub-Saharan Africa. In Nigeria, it is often related to low socio-economic status and ignorance. Existing studies on VVF have focused largely on the biomedical aspects with scant attention given to specific social and cultural factors, that are implicated in its etiology. The study was conducted in Ebonyi and Plateau states, which are culturally divergent and spatially well separated, and have major VVF referral centres accessed by women from diverse locations in Nigeria. The Proximate Determinant Framework was adapted as the theoretical underpinning and quantitative and qualitative methods using the comparative cross-sectional survey design was adopted. A Questionnaire Schedule, In-depth Interviews (IDIs) and key Informant Interviews (KIIs) Guides were used to generate information on the factors that determine the thematic medical condition. Data were content-analysed and findings revealed that respondents perceived cesarean section, patronage of Traditional Birth Attendants (TBA), and evil spirit as factors that lead to VVF. Early marriage and ignorance were also implicated in the incidence of VVF. There were, however, peculiarities in the determinants of VVF in each of the states. For instance, the variance in educational level and age of respondents/age at first birth which impact on direct factors such as duration of labour are indirect factors contributing to VVF. It has been established that improvement in women’s educational status apart from raising their socioeconomic status is also linked to awareness that could bolster activities that prevent VVF in these settings.
Keywords: Vesicovaginal fistula patients, socio-medical determinants of VVF, obstetrics complications.