title: 'As a man I felt small': a qualitative study of Ugandan men's experiences of living with a wife suffering from obstetric fistula.
abstract: The effects of obstetric fistula surpass the individual woman and affect husbands, relatives, peers and the community at large. Few studies have documented the experiences of men who live with wives suffering from fistula. In this study, our objective was to understand how fistula affects these men's lives. We conducted 16 in-depth interviews with men in central and western Uganda. We used thematic narrative analysis and discuss our findings based on Connell's theory of hegemonic masculinity. Findings show that the men's experiences conflicted with Ugandan norms of hegemonic masculinity. However, men had to find other ways of explaining their identity, such as portraying themselves as small men but still be responsible, caring husbands and fathers. The few individuals who married a second wife remained married to the wife with the fistula. These men viewed marriage as a lifetime promise before God and a responsibility that should not end because of a fistula. Poverty, love, care for children and social norms in a patriarchal society compelled the men to persevere in their relationship amidst many challenges.
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Makerere University College of Health Sciences/Mulago National Referral Hospital , Kampala , Uganda.|b Department of Public Health Sciences , Global Health, Karolinska Institutet , Stockholm , Sweden.
authors.forename: Justus Kafunjo
authors.initials: JK
authors.lastname: Barageine
authors.affiliation: b Department of Public Health Sciences , Global Health, Karolinska Institutet , Stockholm , Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Faxelid
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, Makerere University College of Health Sciences/Mulago National Referral Hospital , Kampala , Uganda.
authors.forename: Josaphat K
authors.initials: JK
authors.lastname: Byamugisha
authors.affiliation: b Department of Public Health Sciences , Global Health, Karolinska Institutet , Stockholm , Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Rubenson
mesh_terms: D000328:Adult; D005260:Female; D005402:Fistula / Q000150:complications* / Q000523:psychology; D005783:Gender Identity; D006801:Humans; D008297:Male; D057228:Masculinity; D007744:Obstetric Labor Complications; D011203:Poverty; D011247:Pregnancy; D036301:Qualitative Research; D066262:Social Norms; D018454:Spouses / Q000523:psychology*; D014454:Uganda
keywords: Obstetric fistula; Uganda; hegemonic masculinity; men’s experiences; sexuality