Awareness of obstetric fistula and its associated factors among reproductive-age women in Ethiopia: a multilevel analysis of Ethiopian Demographic and Health Survey data: a cross-sectional study

Abstract

Objective: This study aimed to determine the magnitude and associated factors of obstetric fistula (OF) awareness among reproductive-age women in Ethiopia.

Methods: This community-based cross-sectional study was conducted among 15 683 reproductive-aged women in Ethiopia. Following the presentation of a case vignette, women's OF awareness was measured by asking if they had ever heard of OF. A multilevel multivariable logistic regression analysis was employed. A 95% CI and p<0.05 were used to declare statistical significance.

Result: The magnitude of women's awareness of OF was 38% (95% CI 0.37 to 0.39). Individual level variables including being in the age group of 20-25 (adjusted OR, AOR 1.17; 95% CI 1.02 to 1.35), 26-30 (AOR 1.50; 95% CI 1.27 to 1.76) and >30 (AOR 1.76; 95% CI 1.50 to 2.07), being Muslim (AOR 0.83; 95% CI 0.73 to 0.94), having primary (AOR 1.70; 95% CI 1.53 to 1.89), secondary (AOR 3.43; 95% CI 2.95 to 3.99) and tertiary education (AOR 5.88; 95% CI 4.66 to 7.42), history of pregnancy termination (AOR 1.31; 95% CI 1.13 to 1.51), media exposure (AOR 1.33; 95% CI 1.2 to 1.49), internet use (AOR 2.25; 95% CI 1.84 to 2.75), medium (AOR 1.17; 95% CI 1.02 to 1.34) and rich house hold wealth (AOR 1.50; 95% CI 1.31 to 1.72) and community level factors including high community media exposure (AOR 1.30; 95% CI 1.05 to 1.61), high community antenatal care rate (AOR 1.66; 95% CI 1.37 to 2.02) and low health facility distance problem (AOR 1.49; 95% CI 1.23 to 1.81) were significantly associated with women's awareness of OF.

Conclusions and recommendations: The magnitude of women's awareness of OF was very low in Ethiopia. Awareness of OF was influenced by sociodemographic, economic, obstetric and community-related factors. Thus, tailored public health education is required at the national level to enhance women's awareness of OF.

Keywords: maternal medicine; public health; reproductive medicine; sexual and gender disorders; urogynaecology.