Women's perceptions and experiences of post-operative physiotherapy management at an Obstetric Fistula Center in Eldoret, Kenya

Masters of Science - Msc (Physiotherapy)Post-operative physiotherapy plays a vital role in the management of patients with incontinence in order to optimise the outcome of obstetric fistula surgery. Women who suffer residual urinary incontinence continue to experience shame, social isolation and institutional rejection. Incontinence continues to impair them leading to lower levels of role participation and restriction in most activities. Gynocare Fistula Center, Eldoret, receives a number of referrals for women with obstetric fistula requiring surgical and physiotherapy care. Many studies have focused on the determinants of surgical outcomes and social reintegration but none have focused on woman's perceptions and experiences with postoperative physiotherapy. While continence is not always achieved immediately after surgery, this study was designed to explore women's perceptions and experience of postoperative physiotherapy management at an obstetric fistula center in Eldoret,Kenya. Participants were then asked about their experiences and related perceptions and perceived challenges regarding the physiotherapy service following discharge from the Center. An explorative qualitative method was used to explore the women's perceptions and experiences of the post-operative physiotherapy management, as well as their perceived challenges regarding access to physiotherapy post discharge

Women’s perceptions of post-operative physiotherapy management at an obstetric fistula center in Eldoret, Kenya

Background: Residual Urinary incontinence persists even after successful closure of obstetric fistula that affects women following prolonged obstructed labour. Their ill health relates to reduced physical and functional activity’s to large extend of social exclusion and discrimination. Post-operative physiotherapy plays a vital role in the functional restoration of continence mechanism in order to optimise the outcome of obstetric fistula surgery. If not, this can continue to impair them leading to lower levels of role participation and restriction. Incontinence can, however, be effectively managed if women’s perceptions of physiotherapy and role of post-operative physiotherapy managements understood.Objective: To exploring women perceptions of post-operative physiotherapy management at an obstetric fistula Centre at Eldoret in Kenya.Design: An exploratory design was used to answer research questions.Settings: Gynocare Fistula Center and Maternity Home.Subjects: Thirty-two women agreed to participant in the study. Ten were interviewed and 22 participated in to 3 separate focus group discussions.Results: Lack of interdisciplinary team and patient awareness and understanding of physiotherapy management of their conditions.Conclusion: Participants’ perceptions were reported to have been interfered with by the failure of initial physiotherapy referral amongst the interdisciplinary team and lack of women understanding of the role of physiotherapy management. There is need for knowledge and awareness of physiotherapy services among patients and healthcare providers