Experiential Narratives of Factors Limiting and Boosting Access to Support Services for Women with Obstetric Fistula in Southeast Nigeria.

PURPOSE: Obstetric fistula is a chronic health condition that leaves affected women battered and traumatized, thereby exposing them to social recluse life as a result of associated discomfort and odor. Support services to those with challenging health conditions are reputed to help cushion the adverse effects on them; thus women with fistula and other chronic diseases receiving adequate support will help them to cope and recuperate from such illnesses. This study explores the factors limiting and boosting access to support services for those with obstetric fistulainNigeria. MATERIALS AND METHOD: Focus Group Discussions and In-depth Interviews were employed to obtain data from 44 participants. The thematic data analysis method was deployed in analyzing the data collected. RESULTS: Factors like the limited number of fistula specialist doctors, poor funding, withdrawal from seeking help, long distance, and discrimination limit patients' access to support services and adequate fistula care. The study highlighted that community involvement in fistula care, adequate funding, training, and retraining of professionals will boost support services for fistula patients. CONCLUSION: The study recommends the adoption of a multidisciplinary approach in the management of obstetric fistula patients including the involvement of not only medical personnel but also social workers, families, groups, and community leaders.

Socioeconomic status and health shocks; analysis of coping strategies in rural households of Enugu State, Nigeria

Background: Health burden in rural areas of developing countries is worsened by the limited coverage of health insurance. With constrained access to quality healthcare and constituting two thirds of Nigeria's poor, this study investigates how rural households cope with health shocks consequent on their socioeconomic status. Method: Data was collected from 600 households in Enugu using a questionnaire. Cross-tabulation, chi square and multiple regression statistical techniques were employed for data analysis. Findings: About 53% of the respondents were male household-heads while borrowing (47.65%), sales of assets (43.85%), diversion of funds (2.00%) and reduced expenditure (6.48%) were the main coping strategies. Education, occupation, and income statistically influenced the coping strategies (P < 0.005) and jointly accounted for 26.5% (R2 = 0.265, P < 0.001) of the variations in coping strategies. Conclusion: Having a rural healthcare policy and mainstreaming the informal sector into the national health insurance scheme will am