STATISTICAL ANALYSIS ON VESICO-VAGINAL FISTULA (VVF) AMONG WOMEN IN EBONYI STATE

CHAPTER ONE

1.0 INTRODUCTION

Vesico-vaginal fistula (VVF), which is known as obstetric fistula is a hole in the vagina that is cause by labour that is prolonged, often for days without treatment that allows the continuous unintentional discharge of urine into the vaginal vault.

One of the most serious injuries of child bearing is obstetric fistula. And usually the baby dies, because the fistula leaves women leaking urine or faeces, or both, it typically results to social isolation, depression and deepening poverty. Left untreated, fistula can lead to chronic medical problem (which means affliction or problem that is extremely serious and slow to heal).

In the year 2000, Nigeria and other members of the United Nations agreed on a number of Millennium Development Goals (MFGs) to improve the welfare of the people in their countries in the 21^st century. The first goal of the MDGs was dedicated to the reduction of poverty and extreme hunger and one of the health related concern reducing material deaths by three-quarters (75%) by the year 2015 (MDGs).

Less than a year to the date set for attaining the MDGs many women still die or get disabled because of pregnancy, labour and child delivery. These ailments and disabilities such as anaemia, obstetric fistula, chronic pelvic inflammatory disease and post-pantum psychosis (women losing their minds after child birth) afflict. In developing countries, the predominant cause of VVF is prolonged obstructed labour (97%). Others causes of VVF include Urologic or gynecology instrumentation, pelvic malignancy, cervical cancer, etc. inflammatory diseases, radiation therapy and trauma.

Statistical record has made us to understand and also shown that almost all the countries of the world have victims of this dreaded health problem Vesico-vaginal fistula (VVF).

National obstetric fistula centre, Abakiliki is a national centre dedicated to the treatment, rehabilitation, training, research, etc on Vesico-vaginal fistula (VVF), prolapsed, cervical and breast cancer screening (for women) and prostate cancer, Abakiliki which was formerly known as the South East fistula centre, Abakiliki was established by the mother and child care initiative (MCCI) of the wife of the Governor of Ebonyi State, Her Excellency, Mrs. Josephine Elechi. The centre was commissioned on the 5^th of December 2008 by the then first lady of the Federal Republic of NigeriaHajiya Dr. TuranYar’adua. The centre was taken over by the Federal Government in May 2011 as a National Reference centre for management of obstetric fistula with mandate for provision of free treatment, training of medical and paramedical personnel, Rehabilitation, Research and prevention. Thus far, the centre is free, such that when a women is admitted all her expenses are covered (including medical care, drugs, laboratory tests, food, toiletries and so on). On arrival, she receives a small bag with personal items (e.g. soap, sanitary pads, a plastic container for strong water etc.)

Over seventy percent of the Nigerian population lives in the rural area and the urban suburbs. These greater bulks of the Nigerian population in the rural area and suburbs are mainly constituted by the vulnerable groups are saddled with limited expenditure on priority social sectors that benefit them, absence of the governance structures that bring the voiles of the marginalized people into public setting, lack of transparency in the use of public funds for basic services, and the exclusion of women and girls from family and community decision making.

The major factors associated with Vesico-vaginal fistula are deeply embedded in political, economic and social determinants that underline poverty and vulnerability.

Ebonyi State, the youngest in the South-East geo-political zone of Nigeria is a typical example of the manifestation of this canker worm in the fabrics of our society some years back.

1.4 HYPOTHESIS

H_o: the number of Vesico – vaginal fistula cases are the same among women in all the ages and in all the years

H₁: the number of Vesico – vaginal fistula cases are not the same among women in all the ages and in all the years.

H_o: the Vesico Vagina Fistula disease among women decreases as the year go by.

H₁: the Vesico Vagina Fistula disease among women does not decrease as the year go by.

1.5 SIGNIFICANCE OF THE STUDY

1.6SCOPE OF THE STUDY

This study covered only those that were affected by this health problem VVF (Vesico-vaginal fistula) and were recorded in the National fistula centre at Abakiliki in Ebonyi State, Nigeria. The period covered for the study was 2009 - 2015. This means that those that suffered this problem and was not reported in the hospital centre were not part of the study.

1.7 DEFINITION OF TERMS

1. BACKGROUND OF THE STUDY
1. JUSTIFICATION OF THE STUDY
1. AIMS/ OBJECTIVES OF THE STUDY
2. To estimate the trend of VVF in Ebonyi State
3. To make forecast on future position of VVF in Ebonyi state
4. To test whether the number of VVF cases are the same among women in all the ages and in all the years
5. To examine whether ANC attendants depends on one’s level of education
6. To know whether age at marriage is dependent on any of the socio demographic variables
7. To make recommendation based on my findings.
VVF – stands for Vesico-vaginal fistula. This means an abnormal hole between the urinary bladder and the vagina leading to involuntary discharge of urine into the vagina.
WHO – World Health Organization
UGF – Urogenital fistula
ANC – Antenatal care also known as prenatal care. Is a type of preventive healthcare with the goal of providing regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy while promoting healthy lifestyles that benefit both mother and child.
FMWA – Federal Ministry of Women Affairs
RVF – Rectum Vagina Fistula
GYNECOLOGY – this is the medical practice dealing with the health of the female reproductive systems (Vagina, Uterus and Ovaries) and the breasts.
CAESERCEAN SECTION – this is also known as C – section and it is the use of surgery to deliver one or more babies. It is often performed when a vaginal delivery would put the baby or mother at risk. This may include; obstructed labour, twin pregnancy, high blood pressure in the mother etc.

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