Obstetric Fistula in Sub-Saharan Africa: A Comprehensive Review of Community-Based Strategies for Elimination

Abstract

Obstetric fistula is a devastating childbearing injury that results from poorly managed prolonged obstructed labour without timely surgical intervention. The effects of this injury are long-lasting, and profound as the women become incontinent and marginalized from their communities. While clinical interventions such as conservative care and surgical repair, remain central to its treatment and prevention, community-based initiatives play a critical yet underutilised role in addressing the broader social and structural determinants of obstetric fistula. This review explores the community-based support initiatives focusing on strategies in promoting early identification, recovery, reintegration, and long-term prevention of obstetric fistula. These community-driven approaches not only impact the health of fistula survivors but also contribute to community empowerment and transformation of sociocultural norms in eliminating obstetric fistula. Key community-based interventions include educational programs, stigma reduction efforts, empowering fistula survivors as advocates, and engaging community and religious leaders to enhance awareness and care-seeking behaviour. To effectively eliminate obstetric fistula and restore dignity to affected women, a multi-sectoral, context-specific strategy that integrates medical care with community-driven psychosocial and advocacy interventions is essential to improve quality of life to fistula survivors.