Development and Pilot Test of a Multi‑Component Intervention to Support Women’s Recovery from Female Genital Fistula
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Date
2024-06-24
Journal Title
Journal ISSN
Volume Title
Publisher
Int Urogynecol J
Abstract
We evaluated a pilot multi-component reintegration intervention to improve women’s physical
and psychosocial quality of life after genital fistula surgery.
Twelve women undergoing fistula repair at Mulago Specialized Women and Neonatal Hospital (Kampala, Uganda)
anticipated in a 2-week multi-component intervention including health education, psychosocial therapy, physiotherapy, and
economic investment. We assessed feasibility through recruitment, retention, and adherence, acceptability through intervention
satisfaction, and preliminary effectiveness through reintegration, mental health, physical health, and economic status.
We collected quantitative data at enrollment, 6 weeks, 3 months, and 6 months. We conducted in-depth interviews with six
participants. Quantitative data are presented descriptively, and qualitative data analyzed thematically.
Participants had a median age of 34.5 years (25.5–38.0), 50% were married/partnered, 42% were separated, 50$ had
completed less than primary education, and 67% were unemployed. Mean number of sessions received was 12 for health
education (range 5–15), 8 for counseling (range 8–9), and 6 for physiotherapy (range 4–8). Feasibility was demonstrated by
study acceptance among all those eligible (100%); comfort with study measures, data collection frequency and approach;
and procedural fidelity. Acceptability was high; all participants reported being very satisfied with the intervention and each
of the components. Participant narratives echoed quantitative findings and contributed nuanced perspectives to understanding
approach and content.
Our results suggest that the intervention and associated research were both feasible and acceptable, and suggested
certain modifications to the intervention protocol to reduce participant burden. Further research to determine the
effectiveness of the intervention above and beyond surgery alone with regard to the health and well-being of women with
fistulas is warranted.
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Citation
Barageine, J.K., Nalubwama, H., Obore, S. et al. Development and Pilot Test of a Multi-Component Intervention to Support Women’s Recovery from Female Genital Fistula. Int Urogynecol J 35, 1527–1547 (2024). https://doi.org/10.1007/s00192-024-05814-3