# Knowledge of obstetric fistulas and associated factors among women of reproductive age in Ethiopia: Systematic review and meta‐analysis

## TL;DR

This study finds that only about 44% of women of reproductive age in Ethiopia know about obstetric fistulas, with urban residence and access to healthcare being key factors.

## Contribution

The study provides the first pooled prevalence of knowledge of obstetric fistulas in Ethiopia and identifies specific associated factors.

## Key findings

- The pooled prevalence of knowledge of obstetric fistulas among reproductive-age women in Ethiopia is 43.9%.
- Urban residence and access to antenatal care are strongly associated with higher knowledge of obstetric fistulas.
- Women with formal education and those living near health facilities are more likely to know about obstetric fistulas.

## Abstract

Obstetric fistula is a complication occurring in childbearing women. It is a major problem in developing countries and results in poor childhood development and limited use of obstetric care. The aim of this study was to show the pooled prevalence of knowledge of obstetric fistulas among reproductive age women.

Several databases and websites were searched to find articles. Studies conducted on the knowledge of obstetric fistula and associated factors in women of reproductive age in Ethiopia up to February 20, 2023, were included. Data collection and analysis: The Joanna Briggs Institute Meta‐Analysis of Statistics Assessment and Review Instrument for cross‐sectional study was used for quality assessment, and the Preferred Reporting Items for Systematic reviews and Meta‐Analysis guidelines were used for review. Seven studies were included in total. Pooled prevalence was calculated using a random effect model, and subgroup analysis was carried out. Egger's and Begg's tests were used to assess for publication bias. Finally, tests were conducted to determine the impact of related factors on obstetric fistula knowledge.

The pooled prevalence of knowledge of obstetric fistula among reproductive age women was 43.9%. Attending formal education (AOR = 3.74, 95% confidence interval [CI] = 1.43, 6.05), urban residence (AOR = 4.65, 95% CI = 2.79, 6.52), having antenatal care (ANC) history (AOR = 5.69, 95% CI = 2.03, 9.3), having family planning (FP) history (AOR = 2.5, 95% CI = 1.11, 3.9), home distance from health institution that took ≤30 min by foot (AOR = 3.85, 95% CI = 2.47, 5.23), and ever having been pregnant (AOR = 2.68, 95% CI = 1.25, 4.11).

In this study, most women of reproductive age did not know anything about obstetric fistulas. Knowledge about obstetric fistulas was strongly associated with living in an urban area, walking ≤30 min to and from a medical facility, having a history of ANC or FP, and having ever been pregnant. Therefore, it is important to advocate for women's education, access to maternity and child health services, communication with medical professionals, and proximity to health facilities.