Group Psychological Therapy in Obstetric Fistula Care: A Complementary Recipe for the Accompanying Mental Ill Health Morbidities?

Oladosu A. Ojengbede, Yvonne Baba, Imran O. Morhason-Bello, Margret Armah, Alex Dimiti, Dragudi Buwa, Makur Kariom


The objective of this study is to determine the impact of group psychological therapy (GPT) on the mental health of obstetric fistula patients. It was a comparative pre and post intervention design. All patients had GPT prior to surgery and mental health assessment conducted before and after surgical repair. There was a significant reduction in proportion of those with severe mental health status after surgery.  Specifically, the proportion of those with depression score of 4 and above reduced from 71.7% to 43.4%, and those with score of less than 4 increased from 28.3 to 56.6 percent. There was a significant reduction in those with very low self-esteem from 65.0% to 18.3%. Suicidal ideation reduced generally; severe (15.0 to 0%), moderate (16.7 to 5.0%) and mild (25.0 to 21.7%) and those without increased (43.3 to 73.3%). In conclusion, GPT is a useful adjunct to OF care as it improves their overall mental health status. (Afr J Reprod Health 2014; 18[1]: 156-160).


Keywords: Obstetric fistula, mental ill health, Group Psychotherapy, South Sudan



L'objectif de cette étude est de déterminer l'impact du groupe thérapie psychologique (GPT) sur la santé mentale des fistules obstétriques les patients. C'était un comparatif pré et post-conception de l'intervention. Tous les patients avaient GPT avant la chirurgie et évaluation de santé mentale effectuée avant et après réparation chirurgicale. Il y a eu une réduction significative en proportion de celles souffrant d'une grave maladie mentale statut après la chirurgie. Plus précisément, la proportion de ceux à la dépression score de 4 et plus réduit, passant de 71,7 % à 43,4 %, et ceux avec score de moins de 4 a augmenté, passant de 28,3 à 56,6 pour cent. Il y a eu une réduction significative de ceux avec très faible estime de soi de 65,0 % à 18,3 %.  Idées suicidaires réduits en général; de graves (15.0 à 0%), modérée ( 16,7 à 5,0 %) et doux ( 25,0 à 21,7 %) et ceux sans augmentation ( 43,3 à 73,3 %).  En conclusion, GPT est un utile complément à des soins de santé, et elle améliore leur état de santé mentale. (Afr J Reprod Health 2014; 18[1]: 156-160)


Mots-clés: La fistule obstétricale, la mauvaise santé mentale, psychothérapie de groupe, dans le sud du Soudan

Full Text:



Kelly J. Ethiopia: an epidemiological study of vesicovaginal fistula in Addis Ababa. World Health Stat Q. 1995;48(1):15-7.

Ahmad S, Nishtar A, Hafeez GA, Khan Z. Management of vesico-vaginal fistulas in women. Int J Gynaecol Obstet. 2005 Jan;88(1):71-5.

Muleta M, Rasmussen S, Kiserud T. Obstetric fistula in 14,928 Ethiopian women. Acta Obstet Gynecol Scand. 2010 Jul;89(7):945-51.

Wall LL. Obstetric vesicovaginal fistula as an international public-health problem. Lancet. 2006 Sep 30;368(9542):1201-9.

Williams G. The Addis Ababa fistula hospital: an holistic approach to the management of patients with vesicovaginal fistulae. Surgeon. 2007 Feb;5(1):54-7.

Ahmed S, Holtz SA. Social and economic consequences of obstetric fistula: life changed forever? Int J Gynaecol Obstet. 2007 Nov;99 Suppl 1:S10-5.

Alio AP, Merrell L, Roxburgh K, Clayton HB, Marty PJ, Bomboka L, et al. The psychosocial impact of vesicovaginal fistula in Niger. Arch Gynecol Obstet. 2010 Aug 29.

Gharoro EP, Agholor KN. Aspects of psychosocial problems of patients with vesico-vaginal fistula. J Obstet Gynaecol. 2009 Oct;29(7):644-7.

Bangser M, Mehta M, Singer J, Daly C, Kamugumya C, Mwangomale A. Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. Int Urogynecol J Pelvic Floor Dysfunct. 2011 Jan;22(1):91-8.

Ahmed S, Genadry R, Stanton C, Lalonde AB. Dead women walking: neglected millions with obstetric fistula. Int J Gynaecol Obstet. 2007 Nov;99 Suppl 1:S1-3.

Wall LL. Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of northern Nigeria. Stud Fam Plann. 1998 Dec;29(4):341-59.

Taylor-Robinson SD. To South Sudan with operation lifeline Sudan and UNICEF. J R Coll Physicians Lond. 1999 May-Jun;33(3):276-9.

Taha SI. Sudanese women carry a double burden. Special report: women and HIV. AIDS Anal Afr. 1995 Aug;5(4):12.

UNFPA. Briefing note on South Sudan. 2006 [cited Accessed 19th February, 2011]; Available from: Sudan.pdf

Browning A, Fentahun W, Goh JT. The impact of surgical treatment on the mental health of women with obstetric fistula. BJOG. 2007 Nov;114(11):1439-41.

Agronin M. Group therapy in older adults. Curr Psychiatry Rep. 2009 Feb;11(1):27-32.

Anderson FJ, Winkler AE. An integrated model of group psychotherapy for patients with fibromyalgia. Int J Group Psychother. 2007 Oct;57(4):451-74.

Barry JJ, Wittenberg D, Bullock KD, Michaels JB, Classen CC, Fisher RS. Group therapy for patients with psychogenic nonepileptic seizures: a pilot study. Epilepsy Behav. 2008 Nov;13(4):624-9.

Aderigbe Y, Gureje O. The validity of the 28-item General Health Questionnaire in a Nigeria Antenatal Clinic. Social Psychiatry and Psychiatry Epidemiology. 1992;27:280-3.

Johnson KA, Turan JM, Hailemariam L, Mengsteab E, Jena D, Polan ML. The role of counseling for obstetric fistula patients: lessons learned from Eritrea. Patient Educ Couns. 2010 Aug;80(2):262-5.

Goh JT, Sloane KM, Krause HG, Browning A, Akhter S. Mental health screening in women with genital tract fistulae. BJOG. 2005 Sep;112(9):1328-30. 22. Muleta M, Hamlin EC, Fantahun M, Kennedy RC, Tafesse B. Health and social problems encountered by treated and untreated obstetric fistula patients in rural Ethiopia. J Obstet Gynaecol Can. 2008 Jan;30(1):4450.


  • There are currently no refbacks.