title: Obstetric fistulae in West Africa: patient perspectives.
abstract: OBJECTIVE
  The objective of this study is to gain insight into the nature of obstetric fistulae in Africa through patient perspectives.
  
  
  METHODS
  At l'Hôpital Saint Jean de Dieu in Tanguieta, Benin, 37 fistula patients underwent structured interviews about fistula cause, obstacles to medical care, prevention, and reintegration by 2 physicians via interpreters.
  
  
  RESULTS
  The majority of participants (43%) thought their fistulae were a result of trauma from the operative delivery. Lack of financial resources (49%) was the most commonly reported obstacle to care, and prenatal care (38%) was most frequently reported as an intervention that may prevent obstetric fistulae. The majority (49%) of the participants requested no further reintegration assistance aside from surgery.
  
  
  CONCLUSIONS
  Accessible emergency obstetric care is necessary to decrease the burden of obstetric fistulae in Africa. This may be accomplished through increased and improved health care facilities and education of providers and patients.
authors.affiliation: Department of Obstetrics and Gynecology and Women's Health Albert Einstein College of Medicine at Yeshiva University and Montefiore Medical Center, Bronx, NY 10461, USA. lnathan@montefiore.org
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Nathan
authors.forename: Charles H
authors.initials: CH
authors.lastname: Rochat
authors.forename: Bogdan
authors.initials: B
authors.lastname: Grigorescu
authors.forename: Erika
authors.initials: E
authors.lastname: Banks
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D001294:Attitude to Health; D036861:Delivery, Obstetric; D005260:Female; D014943:Global Health; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009017:Morbidity; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D013513:Obstetric Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014719:Vesicovaginal Fistula / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery