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Abstract
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OBJECTIVE: The Demographic and Health Surveys (DHS), which include standardized questions on female genital fistula symptoms, provide a unique opportunity to evaluate the epidemiology of fistula. This study sought to examine associations between self-reported fistula symptoms and experience of gender-based violence (GBV) among women interviewed in DHS surveys.
METHODS: This study used data from thirteen DHS surveys with standardized fistula and domestic violence modules. Data from the most recent survey in each country were pooled, weighting each survey equally. Multivariable logistic regressions controlled for maternal and demographic factors.
RESULTS: Prevalence of fistula symptoms in this sample of 95,625 women ranges from 0.3% to 1.8% by country. The majority of women reporting fistula symptoms (56%) have ever experienced physical violence and more than one-quarter have ever experienced sexual violence (27%), compared with 38% and 13% among women with no symptoms, respectively. Similarly, 16% of women with fistula symptoms report recently experiencing sexual violence-twice the percentage among women not reporting symptoms (8%). Women whose first experience of sexual violence was from a non-partner have almost four times the odds of reporting fistula symptoms compared to women who never experienced sexual violence. These associations indicate a need to investigate temporal and causal relationships between violence and fistula.
CONCLUSIONS: The increased risk of physical and sexual violence among women with fistula symptoms suggests that fistula programs should incorporate GBV into provider training and services. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Language: en |