{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:07:34Z","timestamp":1789628854273,"version":"build-2803163510"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R00HD086232"],"award-info":[{"award-number":["R00HD086232"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and hypothesis<\/jats:title>\n                <jats:p>We evaluated a pilot multi-component reintegration intervention to improve women\u2019s physical and psychosocial quality of life after genital fistula surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Twelve women undergoing fistula repair at Mulago Specialized Women and Neonatal Hospital (Kampala, Uganda) anticipated in a 2-week multi-component intervention including health education, psychosocial therapy, physiotherapy, and economic investment. We assessed feasibility through recruitment, retention, and adherence, acceptability through intervention satisfaction, and preliminary effectiveness through reintegration, mental health, physical health, and economic status. We collected quantitative data at enrollment, 6 weeks, 3 months, and 6 months. We conducted in-depth interviews with six participants. Quantitative data are presented descriptively, and qualitative data analyzed thematically.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Participants had a median age of 34.5 years (25.5\u201338.0), 50% were married\/partnered, 42% were separated, 50$ had completed less than primary education, and 67% were unemployed. Mean number of sessions received was 12 for health education (range 5\u201315), 8 for counseling (range 8\u20139), and 6 for physiotherapy (range 4\u20138). Feasibility was demonstrated by study acceptance among all those eligible (100%); comfort with study measures, data collection frequency and approach; and procedural fidelity. Acceptability was high; all participants reported being very satisfied with the intervention and each of the components. Participant narratives echoed quantitative findings and contributed nuanced perspectives to understanding approach and content.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our results suggest that the intervention and associated research were both feasible and acceptable, and suggested certain modifications to the intervention protocol to reduce participant burden. Further research to determine the effectiveness of the intervention above and beyond surgery alone with regard to the health and well-being of women with fistulas is warranted.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-024-05814-3","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T12:02:02Z","timestamp":1719230522000},"page":"1527-1547","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Development and Pilot Test of a Multi-Component Intervention to Support Women\u2019s Recovery from Female Genital Fistula"],"prefix":"10.1007","volume":"35","author":[{"given":"Justus K.","family":"Barageine","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadija","family":"Nalubwama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Obore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Mirembe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianah","family":"Mubiru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angella","family":"Jean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Akori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Opio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Keyser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"McKinney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abner P.","family":"Korn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shafeesha","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josaphat","family":"Byamugisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M.","family":"El Ayadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"5814_CR1","volume-title":"Intensifying efforts to end obstetric fistula within a decade. Report of the secretary-general. A\/75\/264","author":"United Nations General Assembly","year":"2020","unstructured":"United Nations General Assembly. Intensifying efforts to end obstetric fistula within a decade. Report of the secretary-general. A\/75\/264. New York, NY: United Nations, 2020."},{"key":"5814_CR2","volume-title":"Obstetric fistula & other forms of female genital fistula: guiding principles for clinical management and programme development","author":"UNFPA","year":"2021","unstructured":"UNFPA. Obstetric fistula & other forms of female genital fistula: guiding principles for clinical management and programme development. New York, NY: UNFPA, 2021."},{"key":"5814_CR3","volume-title":"National obstetric fistula strategy (2020\/21\u20132024\/25)","author":"Ministry of Health Uganda","year":"2020","unstructured":"Ministry of Health Uganda. National obstetric fistula strategy (2020\/21\u20132024\/25). Kampala: Ministry of Health Uganda, 2020."},{"issue":"3","key":"5814_CR4","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/S0020-7292(03)00222-4","volume":"82","author":"P Hilton","year":"2003","unstructured":"Hilton P. Vesico-vaginal fistulas in developing countries. Int J Gynaecol Obstet. 2003;82(3):285\u201395.","journal-title":"Int J Gynaecol Obstet"},{"issue":"4","key":"5814_CR5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/BF01901602","volume":"9","author":"P Hilton","year":"1998","unstructured":"Hilton P, Ward A. Epidemiological and surgical aspects of urogenital fistulae: a review of 25 years\u2019 experience in southeast Nigeria. Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(4):189\u201394.","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"issue":"9","key":"5814_CR6","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1097\/00006254-199609000-00024","volume":"51","author":"S Arrowsmith","year":"1996","unstructured":"Arrowsmith S, Hamlin EC, Wall LL. Obstructed labor injury complex: obstetric fistula formation and the multifaceted morbidity of maternal birth trauma in the developing world. Obstet Gynecol Surv. 1996;51(9):568\u201374.","journal-title":"Obstet Gynecol Surv"},{"key":"5814_CR7","volume-title":"Incontinence","author":"LL Wall","year":"2002","unstructured":"Wall LL, Arrowsmith SD, Briggs ND, Lassey A. Urinary incontinence in the developing world: the obstetric fistula. In: Abrams P, Cardozo L, Khoury S, Wein A, eds. Incontinence. Plymouth: Health Publication Ltd, 2002."},{"issue":"7 Suppl 1","key":"5814_CR8","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1097\/00006254-200507001-00002","volume":"60","author":"LL Wall","year":"2005","unstructured":"Wall LL, Arrowsmith SD, Briggs ND, Browning A, Lassey A. The obstetric vesicovaginal fistula in the developing world. Obstet Gynecol Surv. 2005;60(7 Suppl 1):S3\u201351.","journal-title":"Obstet Gynecol Surv"},{"key":"5814_CR9","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/1471-244X-13-236","volume":"13","author":"BM Zeleke","year":"2013","unstructured":"Zeleke BM, Ayele TA, Woldetsadik MA, Bisetegn TA, Adane AA. Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia. BMC Psychiatry. 2013;13:236.","journal-title":"BMC Psychiatry"},{"issue":"11","key":"5814_CR10","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1111\/j.1471-0528.2007.01419.x","volume":"114","author":"A Browning","year":"2007","unstructured":"Browning A, Fentahun W, Goh JT. The impact of surgical treatment on the mental health of women with obstetric fistula. BJOG. 2007;114(11):1439\u201341.","journal-title":"BJOG"},{"issue":"9","key":"5814_CR11","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1111\/j.1471-0528.2005.00712.x","volume":"112","author":"JT Goh","year":"2005","unstructured":"Goh JT, Sloane KM, Krause HG, Browning A, Akhter S. Mental health screening in women with genital tract fistulae. BJOG. 2005;112(9):1328\u201330.","journal-title":"BJOG"},{"issue":"1","key":"5814_CR12","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s12978-017-0372-8","volume":"14","author":"A El Ayadi","year":"2017","unstructured":"El Ayadi A, Byamugisha J, Obore S, et al. Development and preliminary validation of a post-fistula repair reintegration instrument among Ugandan women. Reprod Health J. 2017;14(1):109.","journal-title":"Reprod Health J"},{"issue":"1","key":"5814_CR13","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1111\/tmi.13178","volume":"24","author":"AM El Ayadi","year":"2019","unstructured":"El Ayadi AM, Barageine J, Korn A, et al. Trajectories of women\u2019s physical and psychosocial recovery following fistula repair in Uganda. Trop Med Int Health. 2019;24(1):53\u201364.","journal-title":"Trop Med Int Health"},{"issue":"Suppl 1","key":"5814_CR14","first-page":"S10","volume":"99","author":"S Ahmed","year":"2007","unstructured":"Ahmed S, Holtz SA. Social and economic consequences of obstetric fistula: life changed forever? Int J Gynaecol Obstet. 2007;99(Suppl 1):S10\u20135.","journal-title":"Int J Gynaecol Obstet"},{"issue":"2","key":"5814_CR15","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1017\/S0021932000013304","volume":"13","author":"M Murphy","year":"1981","unstructured":"Murphy M. Social consequences of vesico-vaginal fistula in northern Nigeria. J Biosoc Sci. 1981;13(2):139\u201350.","journal-title":"J Biosoc Sci"},{"issue":"2","key":"5814_CR16","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1093\/hsw\/19.2.120","volume":"19","author":"D Ojanuga","year":"1994","unstructured":"Ojanuga D. Social work practice with childbirth-injured women in Nigeria. Health Soc Work. 1994;19(2):120\u20134.","journal-title":"Health Soc Work"},{"issue":"9509","key":"5814_CR17","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/S0140-6736(06)68188-9","volume":"367","author":"M Bangser","year":"2006","unstructured":"Bangser M. Obstetric fistula and stigma. Lancet. 2006;367(9509):535\u20136.","journal-title":"Lancet"},{"issue":"Suppl 1","key":"5814_CR18","first-page":"S79","volume":"99","author":"OS Shittu","year":"2007","unstructured":"Shittu OS, Ojengbede OA, Wara LH. A review of postoperative care for obstetric fistulas in Nigeria. Int J Gynaecol Obstet. 2007;99(Suppl 1):S79\u201384.","journal-title":"Int J Gynaecol Obstet"},{"issue":"9","key":"5814_CR19","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.1007\/s00192-021-04845-4","volume":"32","author":"L Keyser","year":"2021","unstructured":"Keyser L, McKinney J, Hosterman L, Chen CCG. Rehabilitative care practices in the management of childbirth-related pelvic fistula: a systematic review. Int Urogynecol J. 2021;32(9):2311\u201324.","journal-title":"Int Urogynecol J"},{"issue":"1","key":"5814_CR20","first-page":"155","volume":"18","author":"OA Ojengbede","year":"2014","unstructured":"Ojengbede OA, Baba Y, Morhason-Bello IO, et al. Group psychological therapy in obstetric fistula care: a complementary recipe for the accompanying mental ill health morbidities? Afr J Reprod Health. 2014;18(1):155\u20139.","journal-title":"Afr J Reprod Health"},{"issue":"2","key":"5814_CR21","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/j.pec.2009.11.010","volume":"80","author":"KA Johnson","year":"2014","unstructured":"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. 2014;80(2):262\u20135.","journal-title":"Patient Educ Couns"},{"issue":"1","key":"5814_CR22","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.aogh.2015.02.993","volume":"81","author":"M Watt","year":"2015","unstructured":"Watt M, Wilson S, Sikkema K, Velloza J, Mosha M, Masenga G. Development of an intervention to improve mental health for obstetric fistula patients in Tanzania. Ann Glob Health. 2015;81(1):214\u20135.","journal-title":"Ann Glob Health"},{"key":"5814_CR23","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s40814-017-0178-z","volume":"3","author":"MH Watt","year":"2017","unstructured":"Watt MH, Mosha MV, Platt AC, et al. A nurse-delivered mental health intervention for obstetric fistula patients in Tanzania: results of a pilot randomized controlled trial. Pilot Feasibility Stud. 2017;3:35.","journal-title":"Pilot Feasibility Stud"},{"issue":"1","key":"5814_CR24","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.ijgo.2013.06.032","volume":"124","author":"YJ Castille","year":"2014","unstructured":"Castille YJ, Avocetien C, Zaongo D, Colas JM, Peabody JO, Rochat CH. Impact of a program of physiotherapy and health education on the outcome of obstetric fistula surgery. Int J Gynaecol Obstet. 2014;124(1):77\u201380.","journal-title":"Int J Gynaecol Obstet"},{"issue":"3","key":"5814_CR25","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/j.ijgo.2014.09.028","volume":"128","author":"YJ Castille","year":"2015","unstructured":"Castille YJ, Avocetien C, Zaongo D, Colas JM, Peabody JO, Rochat CH. One-year follow-up of women who participated in a physiotherapy and health education program before and after obstetric fistula surgery. Int J Gynaecol Obstet. 2015;128(3):264\u20136.","journal-title":"Int J Gynaecol Obstet"},{"issue":"2","key":"5814_CR26","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.ijgo.2014.05.009","volume":"127","author":"L Keyser","year":"2014","unstructured":"Keyser L, McKinney J, Salmon C, Furaha C, Kinsindja R, Benfield N. Analysis of a pilot program to implement physical therapy for women with gynecologic fistula in the Democratic Republic of Congo. Int J Gynaecol Obstet. 2014;127(2):127\u201331.","journal-title":"Int J Gynaecol Obstet"},{"key":"5814_CR27","first-page":"S102","volume":"19","author":"L Keyser","year":"2013","unstructured":"Keyser L, Hollander L, McKinney J, Benfield N. The fistula and obstetric rehabilitation initiative: using pelvic floor physical therapy to augment surgical repair of fistula. Female Pelvic Med Reconstr Surg. 2013;19:S102.","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"5814_CR28","unstructured":"Pollaczek L, Tavrow P, Mohamed H. Obstetric Fistula in Kenya a holistic model of outreach, treatment, and reintegration. In: Dworkin S, Gandhi M, and Passano P, editors. Women's empowerment and global health: A twenty-first century agenda. University of California Press. (2016). URL: https:\/\/www.ucpress.edu\/book\/9780520272880\/womens-empowerment-and-global-health"},{"key":"5814_CR29","unstructured":"Uganda Ministry of Health. National Obstetric Fistula strategy. Kampala: MOH, 2011."},{"key":"5814_CR30","volume-title":"Counseling the obstetric fistula client: a training curriculum","author":"F Care","year":"2012","unstructured":"Care F. Counseling the obstetric fistula client: a training curriculum. New York: Engender Health; 2012."},{"issue":"Suppl 1","key":"5814_CR31","first-page":"S117","volume":"99","author":"L De Bernis","year":"2007","unstructured":"De Bernis L. Obstetric fistula: guiding principles for clinical management and programme development, a new WHO guideline. Int J Gynaecol Obstet. 2007;99(Suppl 1):S117\u201321.","journal-title":"Int J Gynaecol Obstet"},{"issue":"9758","key":"5814_CR32","doi-asserted-by":"publisher","first-page":"2086","DOI":"10.1016\/S0140-6736(10)61508-5","volume":"376","author":"V Patel","year":"2010","unstructured":"Patel V, Weiss HA, Chowdhary N, et al. Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. Lancet. 2010;376(9758):2086\u201395.","journal-title":"Lancet"},{"issue":"9","key":"5814_CR33","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.brat.2011.06.012","volume":"49","author":"V Patel","year":"2011","unstructured":"Patel V, Chowdhary N, Rahman A, Verdeli H. Improving access to psychological treatments: lessons from developing countries. Behav Res Ther. 2011;49(9):523\u20138.","journal-title":"Behav Res Ther"},{"issue":"2","key":"5814_CR34","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.cbpra.2013.06.005","volume":"21","author":"LK Murray","year":"2014","unstructured":"Murray LK, Dorsey S, Haroz E, et al. A common elements treatment approach for adult mental health problems in low- and middle-income countries. Cogn Behav Pract. 2014;21(2):111\u201323.","journal-title":"Cogn Behav Pract"},{"issue":"3\u20134","key":"5814_CR35","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1177\/1363461512447608","volume":"49","author":"CA McFarlane","year":"2012","unstructured":"McFarlane CA, Kaplan I. Evidence-based psychological interventions for adult survivors of torture and trauma: a 30-year review. Transcult Psychiatry. 2012;49(3\u20134):539\u201367.","journal-title":"Transcult Psychiatry"},{"issue":"11","key":"5814_CR36","doi-asserted-by":"publisher","first-page":"e100757","DOI":"10.1371\/journal.pmed.1001757","volume":"11","author":"P Bolton","year":"2014","unstructured":"Bolton P, Lee C, Haroz EE, et al. A transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand. PLoS Med. 2014;11(11):e1001757.","journal-title":"PLoS Med"},{"issue":"23","key":"5814_CR37","doi-asserted-by":"publisher","first-page":"3117","DOI":"10.1001\/jama.289.23.3117","volume":"289","author":"P Bolton","year":"2003","unstructured":"Bolton P, Bass J, Neugebauer R, et al. Group interpersonal psychotherapy for depression in rural Uganda: a randomized controlled trial. JAMA. 2003;289(23):3117\u201324.","journal-title":"JAMA"},{"key":"5814_CR38","unstructured":"Byamugisha J, Obore S, Mwanje H, et al. Reintegration to family and community after obstetric fistula surgery: experiences of Ugandan Women. International Society of Obstetric Fistula Surgeons Conference 2014. Kampala, Uganda; 2014."},{"key":"5814_CR39","volume-title":"Implementing physical rehabilitation services into comprehensive fistula and maternity care: a training guide for health care workers","author":"L Keyser","year":"2019","unstructured":"Keyser L, McKinney J. Implementing physical rehabilitation services into comprehensive fistula and maternity care: a training guide for health care workers. Washington, DC: Mama LLC and EngenderHealth\/Fistula Care Plus; 2019."},{"key":"5814_CR40","unstructured":"Association of Microfinance Institutions of Uganda. The Uganda Microfinance Directory 2013\/2014. 2014. http:\/\/www.amfiu.org.ug\/images\/docs\/carol\/Directory2013.pdf. Accessed 1 Nov 2014."},{"key":"5814_CR41","unstructured":"Foundation for Sustainable Development. Microfinance and Microenterprise Issues in Uganda. 2015. http:\/\/www.fsdinternational.org\/country\/uganda\/mfissues. Accessed 1 Nov 2014."},{"issue":"2","key":"5814_CR42","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s10488-010-0319-7","volume":"38","author":"E Proctor","year":"2011","unstructured":"Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65\u201376.","journal-title":"Adm Policy Ment Health"},{"issue":"53","key":"5814_CR43","first-page":"4406164","volume":"10","author":"P Nilsen","year":"2015","unstructured":"Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10(53):4406164.","journal-title":"Implement Sci"},{"issue":"5","key":"5814_CR44","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1002\/nau.20674","volume":"28","author":"A Klovning","year":"2009","unstructured":"Klovning A, Avery K, Sandvik H, Hunskaar S. Comparison of two questionnaires for assessing the severity of urinary incontinence: the ICIQ-UI SF versus the incontinence severity index. Neurourol Urodyn. 2009;28(5):411\u20135.","journal-title":"Neurourol Urodyn"},{"key":"5814_CR45","unstructured":"\u00dcst\u00fcn TB, Kostanjsek N, Chatterji S, Rehm J. Measuring health and disability: manual for WHO disability assessment schedule WHODAS 2.0: World Health Organization; 2010."},{"issue":"9","key":"5814_CR46","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606\u201313.","journal-title":"J Gen Intern Med"},{"issue":"1","key":"5814_CR47","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1186\/s12913-021-07351-x","volume":"22","author":"L Pollaczek","year":"2022","unstructured":"Pollaczek L, El Ayadi AM, Mohamed HC. Building a country-wide fistula treatment network in Kenya: results from the first six years (2014\u20132020). BMC Health Services Res. 2022;22(1):280.","journal-title":"BMC Health Services Res"},{"key":"5814_CR48","doi-asserted-by":"publisher","first-page":"966390","DOI":"10.3389\/fgwh.2022.966390","volume":"3","author":"MA McCammon","year":"2022","unstructured":"McCammon MA, Otondo NA, Kay N. Economic empowerment of the pilot reintegration program for female genital fistula survivors in Kenya during the COVID-19 pandemic. Front Glob Womens Health. 2022;3:966390.","journal-title":"Front Glob Womens Health"},{"key":"5814_CR49","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1111\/j.1471-0528.2008.01900.x","volume":"115","author":"A Browning","year":"2008","unstructured":"Browning A, Menber B. Women with obstetric fistula in Ethiopia: a 6-month follow-up after surgical treatment. BJOG. 2008;115:1564\u20139.","journal-title":"BJOG"},{"issue":"1","key":"5814_CR50","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12905-021-01360-y","volume":"21","author":"TF Debela","year":"2021","unstructured":"Debela TF, Hordofa ZA, Aregawi AB, Sori DA. Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia. BMC Womens Health. 2021;21(1):212.","journal-title":"BMC Womens Health"},{"issue":"23","key":"5814_CR51","doi-asserted-by":"publisher","first-page":"2182","DOI":"10.1056\/NEJMoa1211853","volume":"368","author":"JK Bass","year":"2013","unstructured":"Bass JK, Annan J, McIvor Murray S, et al. Controlled trial of psychotherapy for Congolese survivors of sexual violence. N Engl J Med. 2013;368(23):2182\u201391.","journal-title":"N Engl J Med"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-024-05814-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-024-05814-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-024-05814-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T06:04:48Z","timestamp":1723183488000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-024-05814-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,24]]},"references-count":51,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["5814"],"URL":"https:\/\/doi.org\/10.1007\/s00192-024-05814-3","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,24]]},"assertion":[{"value":"13 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the University of California San Francisco Institutional Review Board, the Makerere University School of Medicine Research and Ethics Committee (Mak-SOMREC-2020\u201337), and the Uganda National Council on Science and Technology. All participants provided written confirmation of informed consent to participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}