Social reintegration and rehabilitation of obstetric fistula patients before and after repair in Sub-Saharan Africa: A systematic review

Aims: To review how social reintegration and rehabilitation processes are being executed among obstetric patients in Sub-Saharan Africa and highlight projects and programs involved. Methods: This is a systematic review involving a search of relevant literature from PubMed, Google scholar, PsychINFO, African Journals Online, Australian Journals Online, and open access journal of international organizations such as WHO, UNFPA, USAID, Engender Health, Fistula Foundation, and Fistula Care Plus published between 1978 to date. Of the 46 articles identified, 25 were suitable for achievement of this study’s purpose. Results: Sub-Saharan African countries have recognized the overall burden of obstetric fistula and have devised strategies for its’ holistic management. Most countries have National Obstetric Fistula Strategic Frameworks which emphasize multi-sectoral and multidisciplinary approaches other than medical paradigm. Extraordinary among others are: Nigeria, Uganda, Tanzania and Guinea while some countries such as Benin Republic, Chad, Malawi, Mali, and Zambia lack support the at policy level, and have inadequate community outreach programmes. Social reintegration and rehabilitation have been done through the identification of individual patient’s need/s. Upon discharge from hospital, they are counseled, given soap, clothes, transportation fund and are referred to community based projects for elementary education and skills development. Projects and programmes aiming to combat obstetric fistula and restore patients’ self-worth and dignity are: Lamaneh Suisse, and Delta Survie in Mali, Dimol in Niger, Medecins Sans Frontieres (MSF) in Burundi, FORWARD in Nigeria and Sierra Leone, Handicap International in Benin Republic, Women For Africa in Ghana and Liberia, TERREWODE and CoRSU both in Uganda, Hamlin Fistula Ethiopia in Ethiopia, and Safe Motherhood Initiative, Fistula Foundation, Fistula Care Plus, Engender Health, UNFPA, AMREF for Health, WHO and others which cut across the region. Conclusions: Most Sub-Saharan countries have registered progress in assuring effective social reintegration and rehabilitation of obstetric fistula patients although some are still grappling with the issue due to lack of political commitment and inadequate outreach programmes. There is scanty information regarding reintegration and rehabilitation before obstetric fistula repair and yet it would hasten physical and mental wellbeing of the patients as they await repair.

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Social Reintegration and Rehabilitation of Obstetric Fistula Patients Before and After Repair in Sub-Saharan Africa: A Systematic Review

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v13i2.21714 ◽

2018 ◽

Vol 13 (2) ◽

pp. 5-14

Author(s):

Atuhaire Shallon ◽

Oladosu A. Ojengbede ◽

John Francis Mugisha ◽

Akin-Tunde A. Odukogbe

Keyword(s):

Systematic Review ◽

Obstetric Fistula ◽

Relevant Literature ◽

Sub Saharan Africa ◽

Vaginal Fistula ◽

African Countries ◽

Social Reintegration ◽

Open Access Journals ◽

Before And After ◽

Sub Saharan

Aims: Social reintegration and rehabilitation of obstetric fistula patients before and after repair enhance their overall status, which may be unattainable even with a successful repair. Nonetheless, there is little traceable documentation about it even with supportive programs and projects, the thrust of this study. Methods: This is a systematic review involving a search of relevant literature from PubMed, Google scholar, PsychINFO, African Journals Online, Australian Journals Online, and open access journals of international organizations such as WHO, UNFPA, USAID, Engender Health, Fistula Foundation and Fistula Care Plus published between 1978 to date. Of the 46 articles identified, 25 were suitable for achievement of this study’s purpose. Results:Sub-Saharan African countries have recognized the overall burden of obstetric fistula and have devised strategies for its holistic management. Most countries have National Obstetric Fistula Strategic Frameworks which emphasize multi-sectoral and multidisciplinary approaches other than medical paradigms. Social reintegration and rehabilitation have been done through the identification of individual patient’s need/s. Projects and programs aiming to combat obstetric fistula and restore patients’ self-worth and dignity are: Lamaneh Suisse, and Delta Survie in Mali, Dimol in Niger, Medecins Sans Frontieres (MSF) in Burundi, FORWARD in Nigeria and Sierra Leone, Handicap International in Benin Republic, Women For Africa in Ghana and Liberia, TERREWODE and CoRSU both in Uganda, Hamlin Fistula Ethiopia in Ethiopia, and others which cut across the region. Conclusions: Effective social reintegration and rehabilitation strategies are still inadequate in Sub-Saharan Africa due to lack of political commitment and inadequate outreach programs. Keywords: obstetric fistula, recto-vaginal fistula, rehabilitation, social reintegration, vesico-vaginal fistula.

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Khat chewing and risky sexual behavior in Sub-Saharan Africa: a systematic review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2013-877 ◽

2013 ◽

Vol 11 (12) ◽

pp. 59-67 ◽

Cited By ~ 4

Author(s):

Amanuel Tesfay Gebremedhin ◽

Hailay Abrha Gesesew ◽

Tariku Dejene Demissie ◽

Mirkuzie Woldie Kerie ◽

Morankar Sudhakar

Keyword(s):

Systematic Review ◽

Sexual Behavior ◽

Risky Sexual Behavior ◽

Sub Saharan Africa ◽

Systematic Review Protocol ◽

Khat Chewing ◽

Review Protocol ◽

Sub Saharan

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Gambling Patterns and Problem Gambling Among Youth in Sub-Saharan Africa: A Systematic Review

Journal of Gambling Studies ◽

10.1007/s10899-021-10001-w ◽

2021 ◽

Author(s):

Byron K. Y. Bitanihirwe ◽

Derrick Ssewanyana

Keyword(s):

Systematic Review ◽

Problem Gambling ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Gambling Patterns

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Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00822-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hafte Kahsay Kebede ◽

Lillian Mwanri ◽

Paul Ward ◽

Hailay Abrha Gesesew

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Hiv Care ◽

Care Services ◽

Validity Assessment ◽

Sub Saharan ◽

Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

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Behavioural interventions promoting condom use among female sex workers in sub-Saharan Africa: a systematic review

African Journal of AIDS Research ◽

10.2989/16085906.2017.1358753 ◽

2017 ◽

Vol 16 (3) ◽

pp. 257-268 ◽

Cited By ~ 7

Author(s):

Uchenna O Okafor ◽

Rik Crutzen ◽

Yauri Aduak ◽

Sylvia Adebajo ◽

Hubertus W Van den Borne

Keyword(s):

Systematic Review ◽

Condom Use ◽

Sex Workers ◽

Female Sex Workers ◽

Sub Saharan Africa ◽

Behavioural Interventions ◽

Female Sex ◽

Sub Saharan

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Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052477 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2477

Author(s):

Panmial Priscilla Damulak ◽

Suriani Ismail ◽

Rosliza Abdul Manaf ◽

Salmiah Mohd Said ◽

Oche Agbaji

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Behavioral Interventions ◽

Controlled Trial ◽

Self Report ◽

Sub Saharan Africa ◽

Art Adherence ◽

Study Characteristics ◽

Combination Study ◽

Sub Saharan

Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.

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