A qualitative exploratory study of post surgical recovery and social reintegration among women with obstetric fistula in Northwest Cameroon

Abstract

Obstetric fistula remains a significant cause of maternal morbidity in sub-Saharan Africa, with long-term physical, psychosocial, and economic consequences. Evidence on integrated recovery outcomes in Cameroon is limited. The study aims to explored post-surgical recovery, psychosocial adjustment, and socioeconomic re-integration among women treated for obstetric fistula in Northwest Cameroon. A qualitative exploratory design was used to explore the experiences of 29 women who had undergone obstetric fistula repair and completed a minimum of six months of follow-up at Mbingo Baptist Hospital. Quantitative data on socio-demographics, fistula type, continence status, and surgical history were analysed descriptively. Qualitative data from in-depth interviews conducted between September and November 2024 were analyzed thematically to explore lived experiences of recovery and reintegration. Most participants (21/29, 72.4%) had vesicovaginal fistula (VVF). At discharge, 27/29 (93.1%) were continent; at six-month follow-up, 24/29 (82.8%) reported no urinary leakage (no participant had fecal leakage by six months). The median monthly household income was $50 (IQR $25–$90), and participants had a median of two surgeries (IQR 1–3). Three broad qualitative themes emerged from the interviews: (1) Physical and emotional recovery: surgery stopped the constant leakage for most women, restoring their health and self-worth while compassionate treatment and counseling provided psychosocial support and relief from shame; (2) Social reintegration and Stigma: although many participants were accepted by their families and communities, some continued to experience rejection and social stigma; and (3) Economic Empowerment and Livelihood: vocational training and livelihood support enabled women to regain financial independence and social status. Obstetric fistula programs should adopt a holistic approach that combines surgical treatment with ongoing psychosocial support, community education to reduce stigma, and livelihood assistance, to fully address women’s post-surgical needs and restore their dignity.