Assessing Strategies of Obstetric Fistula Management by Nurses/Midwives of Yaoundé Central Hospital and University Teaching Hospital

Every minute, a woman dies in pregnancy, and for every woman who dies 20 - 30 others will survive with morbidity, one of which is obstetrical fistula. Women who suffer from obstetric fistula experience continuous incontinence of urine and/or stool, stigma, social isolation and associated health problems. The World Health Organization estimates that there are currently more than 2 million women living with untreated obstetric fistula mostly in sub-Saharan Africa and South-East Asia, as well as in various other parts of the world. Caring for fistula patients and nursing them back to full physical and mental health can be one of the most challenging and also rewarding tasks undertaken by nurses. The surgery cannot succeed without proper pre-, peri- and post-operative care. The patients undoubtedly recover better with high-quality care—meaning the truly holistic, generous, and selfless care of a nurse who has the skills, understanding and determination to help these very vulnerable patients. Objective: This research seeks to assess the strategies of obstetric fistula management by nurses/midwives of Yaoundé central hospital and CHU by exploring the care they offer to clients pre-operatively, post-operatively, and when they are discharged from the hospital. Achieving Millennium Development Goal (MDG) 3 still remains a challenge to the developing countries although maternal mortality reduction is a priority agenda of each country. Methodology: This retrospective cross-sectional descriptive study design employed a sample of 100 nurses/midwives on active service, and who have at least managed a case of obstetric fistula. A quantitative questionnaire was used to collect data, which was analyzed using SPSS version 23. Results: The study proved a highly significant difference between management and qualification, with a p-value of 0.002. Also, it showed that there was a statistically significant difference between longevity of service and management with a p-value of 0.001. A majority of respondents were nurse assistants (52%), and up to 43% of respondents had 11 - 20 years of work experience. Up to 53% did not offer standard care with respect to their qualification, and up to 52% did not offer standard care with respect to their longevity in service. Conclusion: VVF is the most common type of obstetric fistula with a frequency of 6 to 10 cases, there is an overall poor management of obstetric fistula by nurses and midwives in YCH and CHU. There is an urgent need to train and retrain these health workers on the management strategies of obstetric fistula and to remind them of their personal commitment as care givers.