Socio-demographic and reproductive health profile of women who experienced signs of obstetric fistula: Results from Pakistan Demographic and Health Survey (PDHS) 2006-2007.

OBJECTIVE: to examine the socio-demographic profile of women experiencing signs of obstetric fistula and factors contributing to the development of this condition in Pakistan.

METHODS: secondary data analysis of Pakistan Demographic and Health Survey 2006-07, which for the first time measured signs of obstetric fistula, using a questionnaire at a population level. For the present study, questions directly related to obstetric fistula signs were used to construct a dependent variable. Data were analysed by descriptive and logistic regression analysis, to examine factors associated with development of fistula.

FINDINGS: among women of reproductive age (n = 9134, aged 15-49 years), some 277 (3.0%, 30 per 1000 women who ever gave birth) experienced obstetric fistula signs, whereas 103 (1.1% of all women) were still experiencing the condition at the time of survey. In a logistic regression model, women from the Punjab region (OR = 5.67, 95%CI = 2.10-15.31), women who delivered by caesarean section (OR = 1.91, 95% CI = 1.06-3.42) and reported having complications during pregnancy were more likely to develop obstetric fistula (OR = 1.96, 95%CI = 1.19-3.16).

CONCLUSIONS: Obstetric fistula is one of the neglected public and reproductive health concerns in Pakistan. To eliminate this preventable tragedy, there is a need for better emergency obstetric care facilities and the availability of a fistula repair service throughout the country.