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Characteristics and obstetric histories were obtained by self\u2010report.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the 202 participants at treatment was 30.7 years (range 5\u201369). The mean duration of fistula was 45.6 months (range 0\u2013600). In total, 171 (91.4%) fistulas were caused by obstructed labor, and 147 (86.5%) were vesicovaginal. Most women (129\/175 [73.8%]) reported having received care during early labor under the supervision of a nurse or doctor in a healthcare facility. Among 176 women for whom delivery data were available, 102 (57.9%) delivered at a hospital, 42 (23.8%) at a health center, and 32 (18.2%) at home. Only 46 (26.3%) of 175 women were transferred to a higher level of care during labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the eastern DRC, efforts to enable transport to a healthcare facility and to encourage attended births must be accompanied by improvements in the capacity of existing facilities and in the training of staff to enable the timely diagnosis of labor abnormalities and appropriate intervention.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2015.02.032","type":"journal-article","created":{"date-parts":[[2015,5,2]],"date-time":"2015-05-02T21:31:37Z","timestamp":1430602297000},"page":"157-160","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Fistula after attended delivery and the challenge of obstetric care capacity in the eastern Democratic Republic of Congo"],"prefix":"10.1002","volume":"130","author":[{"given":"Nerys","family":"Benfield","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nichole","family":"Young\u2010Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Kimona","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc M.","family":"Kalisya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogatien M.","family":"Kisindja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,4,30]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.032"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69476-2"},{"key":"e_1_2_6_4_2","unstructured":"United Nations Population Fund EngenderHealth Obstetric fistula needs assessment report: findings from nine African countries.http:\/\/www.unfpa.org\/fistula\/docs\/fistula\u2010needs\u2010assessment.pdf Published 2003. 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