Knowledge of obstetric fistula and its associated factors among reproductive age women in North Kivu Province (Democratic Republic of the Congo): A community-based cross-sectional study.

BACKGROUND

Obstetric fistula (OF) is a severe and debilitating complication of childbirth that primarily affects women in developing countries, particularly the Democratic Republic of the Congo. It results in chronic urinary and/or fecal incontinence, often accompanied by social isolation, stigma, and psychological distress, thereby having a profound negative impact on the quality of life of affected women.

OBJECTIVES

This study aims to evaluate the level of awareness and knowledge regarding OF among Congolese women of reproductive age in the North Kivu Province.

DESIGN

This is a community-based, cross-sectional study.

METHODS

A two-stage cluster random sampling method was employed to select a sample of 500 women aged 15-49 years. Data were collected using a pretested, semi-structured questionnaire administered through face-to-face interviews. The questionnaire gathered information on sociodemographic characteristics, reproductive history, and knowledge of OF. Data were analyzed using descriptive statistics and binary logistic regression to identify factors associated with a good OF knowledge.

RESULTS

The mean age of respondents was 33.7 ± 10.4 years. Among the 467 surveyed, 22.7% demonstrated good OF knowledge. Urban residence (adjusted odds ratio, aOR = 2.8, 95% CI [1.6-4.6]; p < 0.0001), being single (aOR = 2.6, 95% CI [1.3-4.6]; p = 0.0078), lack of professional occupation (aOR = 1.7, 95% CI [1.0-2.7]; p = 0.0407), use of family planning services (aOR = 1.9, 95% CI [1.2-3.2]; p = 0.0111), and personally knowing someone who had suffered from OF (aOR = 9.6, 95% CI [2.0-46.9]; p = 0.0052) were independently associated with good OF knowledge.

CONCLUSION

The study revealed that a substantial proportion of women in North Kivu province have limited knowledge about OF. Strengthening awareness and education efforts, particularly in rural settings, is essential to promote early recognition of symptoms and timely care-seeking behavior. Targeted health education programs and community-based interventions are crucial to improving understanding and reducing the burden of this preventable condition. Moreover, identifying the determinants of good OF knowledge can inform the design of more effective prevention and intervention strategies at the elimination of this condition.