Marital disruption among women with genital fistula in Nigeria: who is at greatest risk?

INTRODUCTION AND HYPOTHESIS: Marital disruption is a commonly identified sequela of genital fistula in developing countries. This study is aimed at identifying factors that correlate with marital outcomes.

METHODS

All new patients presenting to Evangel VVF Centre in Jos, Nigeria, between August 2015 and August 2017, were retrospectively reviewed with regard to demographics, medical history, and fistula details to identify variables correlating with marital status, particularly whether currently married or presently divorced, separated, or divorced and remarried (cumulatively the "divorce group").

RESULTS

Among 581 new patients, 66% were married and 18% experienced marital disruption. Presence of living children in the home and having attended any level of formal education were found to be protective of marriage (p values <0.0001 and 0.0045 respectively). Patients in the divorce group were more likely to have delivered a baby before the age of 18, be of Muslim background, and have a longer time since fistula formation (p values all <0.0001), as were those married younger than 18 and those whose fistula followed a vaginal delivery (p values 0.0015 and 0.0017 respectively).

CONCLUSION

Several factors correlate with disruption of the marriage relationship. Patients at highest risk for marital disruption should be identified early and provided with interventions aimed at protecting their marriage and social support system.