Assessment of IEC activities in the prevention and management of obstetric fistula in the Savelugu-Nanton District.

Obstetric fistula is a hole that is created between the vagina and bladder or between the vagina and rectum or both, caused by several days of obstructed labour. As a result, the victim is unable to control her flow of urine or faeces. The World Health Organization has estimated that at least 50,000 to 100,000 cases of obstetric fistula occur every year and that more than two million women with obstetric fistula remained untreated in developing countries. In 2005, a project dubbed 'Strengthening Obstetric Fistula Prevention Activities and Access to Treatment in Ghana' was launched as part of the global campaign to prevent and manage Obstetric Fistula. The project areas were the Northern, Upper East and Upper West Regions, where the condition is said to prevail. One of the strategies of the campaign involved using IEC activities to create awareness and change behaviour of the communities with the aim of promoting good maternal health practices as a way of preventing the condition. But between the periods of January 2005 when the project was launched and in December 2007, the Tamale Teaching Hospital, which was the major referral point in the Northern region, had registered about 53 women with obstetric fistula. The Savelugu-Nanton district was the only district that had not reported any case. This study was to help identify how the Information Education and Communication (IEC) activities were carried out in the Savelugu-Nanton district under the project and also to determine the prevalence of obstetric fistula in the district. A total of 250 respondents were interviewed in the district. The respondents were in three categories and their aggregate responses helped to arrive at the findings. They included (i) Community members; to ascertain their level of knowledge and attitude about maternal health in general and obstetric fistula in particular. The second category of respondents were the Traditional Birth Attendants- (TBAs); to assess the type/s of IEC activities they use in maternal health in general and obstetric fistula in particular. TBAs play various roles in maternal health delivery in the district. The third category were the formally trained health personnel who provided maternal and child health services in health institutions in the district. Their role was to help determine, among others, the availability of IEC activities in the prevention of obstetric fistula in the health facilities. The study revealed that there were cases of obstetric fistula in the district but knowledge about obstetric fistula was low. Only 61 (29%) of the 210 community members interviewed said they had heard of obstetric fistula. The study attributed that to the absence of effective IEC activities in the prevention and management of obstetric fistula in the district. This was buttressed by the revelation that there were no IEC materials on obstetric fistula in all the five health facilities in the district. The TBAs, according to the study also lacked adequate skill on promoting maternal health education and fistula in particular. The study further revealed that health service providers were the most trusted source of health information and the mass media, particularly; radio was the appropriate channel of information for the community members. The study therefore concluded that health service providers should be given adequate support to use the mass media (Radio, Television and Newspapers) to undertake IEC activities on maternal health and obstetric fistula in particular in the district. The study also identified group communication (community durbars, workshops, neighborhood meetings) as another convenient channel that could be explored to support the campaign on obstetric fistula in the district.

Source: KNUST