Assessment of Psychosocial Implication of Vasico Vaginal Fistula Among Patients Attending (VVF) Center Jahun Jigawa State.
CHAPTER ONE
Objectives of the Study
Generally, every research is goal-oriented; the goal must be stated in clear terms to enable its realization. The broad objective of this study therefore is to assess the psychosocial implication of vasico vaginal fistula among patients attending (VVF) center Jahun, Jigawa state. Specifically, the research sought:
- To find the level of exposure of the people in Jahun, Jigawa state, Nigeria on Vesico Vagina Fistula campaigns.
- To ascertain the knowledge level of the people in Jahun, Jigawa state, Nigeria on Vesico Vagina Fistula.
- To find out their major sources of information.
- To find out the challenges associated with the use of the media in campaign against VVF
- To ascertain the level of influence of these campaigns in the prevention and control of VVF in North West Nigeria.
CHAPTER TWO
LITERATURE REVIEW
2.0 Introduction
The review of literature consists of both conceptual and empirical review. The conceptual review provides background for the understanding of the study, while the empirical review helped redirect the focus of this study by showing what other researchers have done in regards to VVF. The review is done in the following order:
- An Overview of Vesico Vaginal Fistula.
- Causes of Vesico Vaginal Fistula.
- Psycho -Social Consequences of VVF on its Victims
- Review of Empirical Studies
- Theoretical Framework
Conceptual Review
An Overview of Vesico Vaginal Fistula.
Vesico Vagina Fistula (VVF) is an abnormal fistulous tract extending between the bladder and the vagina. The abnormality allows for the continuous and involuntary discharge of urine into the Vagina vault (Forsgren, Lundholm, & Johansson, 2009, p. 8). In a report by Villey (2006 p.3), “VVF is an abnormal communication between the urinary bladder and the vagina that results in the continuous involuntary discharge of urine into the vaginal vault”
Tracing the earliest discovery and oldest evidence of obstructed fistula, Zacharin (1988, p.5) noted that in 1923 in Cairo, the remains of Queen Henhenit the wife of King Mentuhotep 11 of Egypt (2050 BC) was discovered and detailed clinical examination was carried out on it and the vagina was normal but there was a tear in the bladder which links the vagina. The medical doctor concluded that this must be the cause of her death.
The above has clearly shown that VVF is not new in the globe. Wall (2001, p.895) discovered that “The growth in science and technology mostly in Europe and North America has made the scourge relatively unknown in these geographical regions of the world. Here in Africa, many lives are lost on a daily bases as a result of VVF”. Metro (2006, p.13) observed that,” Fistula is almost oblivion in countries where there is universal health care which takes woman’s health more seriously”. Metro further stated that the causes of VVF in most third world countries centre on obstetric difficulties. He noted that, 90% of such cases are caused by advent bladder trauma during surgery with hysterectomy.
On the contrary, Wall and Lancer (2006, p.1408) observed that, there are cases of VVF in industrialized countries and to a large extent these are due to “radiation therapy or surgery thus distinguishing the etiology from that of developing countries which result mainly from neglect of obstetric compared from that of developed countries, which occur under very different circumstance”.
CHAPTER THREE
METHODOLOGY
Research Design
To effectively evaluate the influence of Media campaigns on Vesico Vaginal Fistula prevention and control in Jahun, Jigawa state, Nigeria, the researcher used explanatory mixed method. This approach enabled the researcher to generate both quantitative and qualitative data and generalize the result on the entire population. Another rationale for this approach, according to Creswell (2002. p 565), is that “one data collection form supplies strengths to offset the weakness of the other form.” With this design, the researcher gathered both quantitative and qualitative data, compared results from the analysis of both data and made statistical interpretations.
Population of the Study
The population of this study covers the entire adults in Jahun, Jigawa state, Nigeria. The population of Jahun, Jigawa state according to National Census, 2006 is 229,094.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
Data Presentation and Analysis
To elicit information from the respondents, 428 copies of the questionnaire were distributed to the people in the selected states of the study. The quantitative analysis is therefore based on the 428 copies of the questionnaire. The Statistical Package for Social Science (SPSS) was used to analyse the copies of questionnaire valid for the study.
The demographic data of the respondents as collected using questionnaire were presented first. This was equally followed by the psychographic data collected to answer the research questions raised.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary
In summary, this study analysed the psychosocial implication of vasico vaginal fistula among patients attending (vvf) center Jahun Jigawa State, Nigeria. In conducting this research, three research instruments were used to collect data. Research questions raised were analysed using Statistical Package for Social Science (SPSS). The data were presented in tables, percentage and bar charts. At the end of the analysis, various findings were made, below is the summary of the major findings:
Research Question one sought to know the level of exposure of respondents to VVF campaigns. The results indicate that the respondents are aware of VVF campaigns in the region, however, the level of exposure is said to be relatively high, in addition to this, both the interview section and the observation made were also in-line with the above finding. This implies that the level of exposure of respondents in respect to the subject of discuss is relatively high.
On the knowledge level of respondents, the results indicates that VVF is associated with all of the followings, early marriage, female genital mutilation, lack of antenatal care and surgical error. Both the interview and the observation carried out were all in-line with the results gotten from the administered copies of questionnaire. This means that their knowledge level is high, and this can be attributed to a large extent as a result of the massive campaigns carried out in the region.
In regards to the major source of information, findings reveals that the repondents got to know about VVF through workshops/seminars, on the other hand, three out of the six health workers interviewed said the major source of their information on VVF is seminars/workshops, the observation carried out revealed that radio and seminars/workshops formed the primary source of information on VVF. Based on this, radio and seminars/workshops formed their major source of information.
In research question four, only interview was used. Health workers were interviewed; they all said there are challenges associated with the use of the media in the campaign against VVF. Some of the challenges are language, timing of the awareness campaign and boring awareness programmes. etc.
The research five questions seek to know the level of influence of the campaigns on VVF prevention and control. The respondents agreed that the campaigns have influenced them to the level that they can take the following preventive measures; going for antenatal care, stopping early marriage and stopping female genital mutilation. The result gotten from the interview and observation attests to the above. The interview shows that the campaigns have influenced them to the point that they seek modern medical attention, go for antenatal classes and as well know that VVF is repairable. One of the interviewees stated that despite the influence of the campaigns that they still engage in early marriage and pregnancy. The observation is also in line with the above. The researcher observed that they do not patronize traditional child birth delivery centers and are all going for antenatal classes. But are still involved in early marriage and pregnancy. Based on the above, the researcher concludes that the level of the influence of the campaigns in prevention and control of VVF is moderately high.
Conclusion
Vesico Vaginal Fistula remains a major public health problem in northern Nigeria. From the findings of this study, the researcher therefore concludes that:
The level of exposure on VVF is high among the people of Jahun, Jigawa state, Nigeria. However, this can be attributed to the massive campaigns carried out in the region by government and NGOs.
Their knowledge level of the disease is high; this can also be linked to the campaigns carried out in the Jahun, Jigawa state, Nigeria on VVF.
Both radio and seminars/workshops formed the major sources of information to the
people in the Jahun, Jigawa state, Nigeria on VVF.
Challenges associated with the use of the media in the campaign against VVF includes language, timing of the awareness campaigns, boring awareness programmes, etc.
The influence of the campaigns on VVF on prevention and control is moderately high among people of Jahun, Jigawa state, Nigeria.
Recommendations
Over the years, VVF has remained a medical and social problem especially to the people of the north; it has also remained a surgical challenge to those in the health sector. However, the good news is that, VVF is treatable and preventable. Going by the findings, this study therefore recommends the following:
The awareness campaigns should include women from different communities in Jahun, Jigawa state, Nigeria and the campaign planners should ensure they use local language during the campaigns; this will aid better understanding of the campaign message.
During the cause of the campaigns, skilled counselors should be used to sensitize and provide adequate information and education to VVF patients and their relatives, so that they in turn can serve as agents of change to their communities.
The campaign should be intensified more on the prevention of prolonged and obstructed labour since it’s the main and commonest cause of VVF.
The campaign will be of tremendous benefit to the communities if it can also cover health education, free antenatal care and free child delivery.
The awareness campaigns should be in the form of community mobilization in which the communities will be made to know the consequences of early marriage, the importance of attending antenatal care should be encouraged and traditional childbirth delivery should be discouraged.
The campaign should strive to renew the hopes and dreams of those who suffer from VVF. The campaign should also aim at reducing the stigma associated with VVF.
More health workers should be trained on how to educate the people on the prevention and treatment of fistula. More specialized centres dedicated exclusively for VVF care with ultra modern facilities should be built in various communities in the Jahun, Jigawa state, Nigeria
There should be an assessment before providing financial backing for the planning of campaigns on VVF and executing the campaigns in the various northern states.
International support should be sought for; agencies like the World- Wide Fund for Mother Injured in Childbirth can provide support for the campaign, treatment and rehabilitation of affected women.
Education can also be very effective in reducing cases of VVF.
The Government should legislate against some traditional practices such as female child circumcision (gishiri cut) and they should improve the socio-economic condition of the populace.
The launch by UNFPA to stop fistula is a welcome idea, but it should not only stop there, more progress will be made if political office holders put this issue as their priority in their national health care agenda.
Finally, further research works on VVF can be carried out to cover the entire northern states of Nigeria.
BIBLOGRAPHY
Journals
- Ahmed, S, Creenga, A. & Tsui, A. (2007). The role of delayed child bearing in the prevention of obstetric fistulas. International Journal of Gynecology and Obstetrics.2(3)5
- Ahmed, S. & Holtz, S.A. (2007). Social and Economic Consequence of Obstetric Fistula: Life changed forever? International Journal of Gynecology and obstetrics. . 2,10
- Akpeji, F. (2012). Vesico- Vaginal Fistula in northern Nigeria. Urogynaecologia International Journal, 2, 5
- Andrew, O. (2011). Africa: The effect of VVF in Africa. International Journal of Gynecology and Obstetrics.2, 6
- Dodson, J.L, Gutman, R, &Mostwin, J. L. (2007). Complications of treatment of obstetric fistula in developing world: Gynastresia, urinary incontinence and urinary diversion. International Journal of Gynecology and Obstetrics 4,(2)223-225
- Donnay, F. & Ramsey, K, (2007). Eliminating obstetric fistula: Progress in partnerships. International Journal of Gynecology and Obstetrics. 4,(2)227-230
- Forsgren, C, Lundholm, C & Johansson, N. (2009). Hysterectomy for benign indications and risk of pelvic organ fistula disease. Obstetrics and Gynecology. 114, 3
- Hilton, P. (2003). Vesico-vaginal fistula in developing counties. International Journa of Gynastresia and Obstetric. 2(3)12
- Ijaiya, M. (2010) Vesico Vaginal Fistula: A review of Nigeria experience. West African Journal of Medicine, 10(5), 293-298. Retrieved January 12, 2020 from http://www.ncbi.nlm.nih.gov/pubmed/21089013
- Johnson, K. (2007). Incontinence in Malawi: Analysis of proxy measure of vaginal fistula in national survey. International Journal of Gynecology and Obstetrics. 3,9.
- Mohammed, R. (2007). A community programe for women’s health and development: Implications for the long term care of women with fistula. International Journal of Gynecology and Obstetrics. 2(5)12-15
- Orji, E, Aduloju, O & Orji, V. (2007). Correlation and impact of obstetric fistula on motherhood. Journal of Chinese Clinical Medicine. 2 ,8
- Raasen,T,Verdaasdonke,E & Vierhout,M (2007). Perspective results after first time survey for obstetric fistulas in east African women. International Urogynecology Journal, 19, pp.73-79
- Ramsey, K, Illiyasu, Z. &Idoko, L. (2007). Fistula fortnight: Innovative partnership brings mass treatment and public awareness towards ending obstetric fistula. International Journal of Gynecology and Obstetrics.9,9 doi: 10.1016/j-ijgo.2007.06.034
