# Supporting Women after Obstetric Fistula Surgery to Enhance Their Social Participation and Inclusion

## TL;DR

This study explores how women in Ethiopia are supported after obstetric fistula surgery, highlighting gaps in formal and informal systems that affect their social inclusion and participation.

## Contribution

The study provides new insights into post-surgical support systems for women with obstetric fistula, emphasizing the need for enhanced economic and psychological support.

## Key findings

- Formal support systems have gaps that hinder women's social inclusion after surgery.
- Informal supports also face challenges in adequately addressing women's needs post-surgery.
- Both family and service providers agree that holistic support is needed to improve outcomes.

## Abstract

Obstetric fistula is a childbirth complication causing abnormal openings between the urinary, bowel, and genital tracts, leading to involuntary leakage and potential long-term disability. Even after surgical repair, women continue to face psychological and social challenges that affect their social inclusion and participation. This study explored family and service provider perspectives on current support systems and identified gaps affecting women’s inclusion and participation post-fistula surgery. Building on a prior study of women who underwent obstetric fistula surgical repair, we qualitatively examined available formal and informal post-surgical supports in Ethiopia. We conducted 20 interviews with family members and service providers and analyzed them using Charmaz’s grounded theory inductive analysis approach. We identified four themes that indicated the available formal support in fistula care, the impact of formal support on women’s social participation and inclusion, the gaps in formal support systems, and post-surgery informal supports and their challenges. Both groups believed support needs for women after surgery remain unmet, highlighting the need to strengthen holistic support services to improve women’s social inclusion and participation. This study contributes to limited research on formal and informal support for women, emphasizing the need for enhanced economic, psychological, and sexual health-related support post-obstetric fistula surgery.