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Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement
BACKGROUND: The uneven global and national distribution of obstetric fistulas suggests a complex network of determinants contributing to fistula development. This study aims to create an understanding of the determinants of obstetric fistula in Uganda and to give a framework for health policy improv...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189698/ https://www.ncbi.nlm.nih.gov/pubmed/32349703 http://dx.doi.org/10.1186/s12884-020-02951-7 |
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author | den Hollander, Geerte C. Janszen, Erica W. M. |
author_facet | den Hollander, Geerte C. Janszen, Erica W. M. |
author_sort | den Hollander, Geerte C. |
collection | PubMed |
description | BACKGROUND: The uneven global and national distribution of obstetric fistulas suggests a complex network of determinants contributing to fistula development. This study aims to create an understanding of the determinants of obstetric fistula in Uganda and to give a framework for health policy improvement. METHODS: A scoping review of existing literature was performed, searching the PubMed/MEDLINE database, Ugandan Demographic and Health Surveys, and official sources of Ugandan statistics. Data was analysed using the model for the determinants of health by Dahlgren and Whitehead. RESULTS: Obstetric fistulas are associated with different personal lifestyle factors, certain social and community networks, as well as poor working and living conditions. Malnutrition, early childbearing, limited female empowerment, lack of awareness of childbearing risks, low socioeconomic status, and long distances to emergency obstetric care play a part. Certain regions of Uganda are in particular associated with obstetric fistula, where an accumulation of determinants is notable. CONCLUSION: Analysis using the model of Dahlgren and Whitehead shows that obstetric fistulas are associated with determinants at different levels of society. Poverty and low education link these in a web that is disproportionately hard to escape from for the poorest women. This inequity asks for co-operation between ministries to dismantle the environment for obstetric fistula. |
format | Online Article Text |
id | pubmed-7189698 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-71896982020-05-04 Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement den Hollander, Geerte C. Janszen, Erica W. M. BMC Pregnancy Childbirth Research Article BACKGROUND: The uneven global and national distribution of obstetric fistulas suggests a complex network of determinants contributing to fistula development. This study aims to create an understanding of the determinants of obstetric fistula in Uganda and to give a framework for health policy improvement. METHODS: A scoping review of existing literature was performed, searching the PubMed/MEDLINE database, Ugandan Demographic and Health Surveys, and official sources of Ugandan statistics. Data was analysed using the model for the determinants of health by Dahlgren and Whitehead. RESULTS: Obstetric fistulas are associated with different personal lifestyle factors, certain social and community networks, as well as poor working and living conditions. Malnutrition, early childbearing, limited female empowerment, lack of awareness of childbearing risks, low socioeconomic status, and long distances to emergency obstetric care play a part. Certain regions of Uganda are in particular associated with obstetric fistula, where an accumulation of determinants is notable. CONCLUSION: Analysis using the model of Dahlgren and Whitehead shows that obstetric fistulas are associated with determinants at different levels of society. Poverty and low education link these in a web that is disproportionately hard to escape from for the poorest women. This inequity asks for co-operation between ministries to dismantle the environment for obstetric fistula. BioMed Central 2020-04-29 /pmc/articles/PMC7189698/ /pubmed/32349703 http://dx.doi.org/10.1186/s12884-020-02951-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article den Hollander, Geerte C. Janszen, Erica W. M. Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
title | Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
title_full | Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
title_fullStr | Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
title_full_unstemmed | Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
title_short | Obstetric fistulas in Uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
title_sort | obstetric fistulas in uganda: scoping review using a determinant of health approach to provide a framework for health policy improvement |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189698/ https://www.ncbi.nlm.nih.gov/pubmed/32349703 http://dx.doi.org/10.1186/s12884-020-02951-7 |
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