{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:22:12Z","timestamp":1788870132416,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,3,31]],"date-time":"2014-03-31T00:00:00Z","timestamp":1396224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004448","name":"Aga Khan Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004448","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the prevalence of obstetric fistula, its duration and impact on women's daily life using robust data collection methods in a population\u2010based sample in rural Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A population\u2010based, cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      A rural community in\n                      <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>\n                      indh\n                      <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\n                      rovince,\n                      <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\n                      akistan.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Randomly selected women aged 15\u00a0years or older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multistage random sampling strategy was used to recruit the women. Lady Health Workers interviewed women in their own homes using a structured questionnaire to obtain symptom data. Women with symptoms of incontinence were then examined by female gynaecologists in their local health facilities to confirm obstetric fistula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Obstetric fistula confirmed by gynaecological examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 5064 women interviewed (96% response rate), 20 women with obstetric fistula were identified, showing a prevalence of 0.39% of all women (95% confidence interval [95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ] 0.22\u20130.57%) and 0.45% of parous women (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.25\u20130.65%). Significantly more of the women with obstetric fistula compared with parous women without fistula were primiparae and aged &lt;20\u00a0years. Of the women with obstetric fistula, 40% had had this for &gt;5\u00a0years and 90% reported a major impact on their lives, yet only four had consulted a doctor, three of whom had failed repairs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of obstetric fistula is high in rural Pakistan. Appropriate provision is needed for fistula repair to reduce the burden of the condition. Alongside this, the improvement of maternity care services is urgently needed to prevent its continued occurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.12739","type":"journal-article","created":{"date-parts":[[2014,3,31]],"date-time":"2014-03-31T00:23:30Z","timestamp":1396225410000},"page":"1039-1046","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Prevalence of obstetric fistula: a population\u2010based study in rural\n                    <scp>P<\/scp>\n                    akistan"],"prefix":"10.1111","volume":"121","author":[{"given":"AH","family":"Jokhio","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RM","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"MacArthur","sequence":"additional","affiliation":[{"name":"School of Health and Population Sciences College of Medical and Dental Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,3,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69476-2"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)32712-8"},{"key":"e_1_2_8_5_1","first-page":"193","article-title":"Obstetric fistula: living with incontinence and shame","volume":"1","author":"Semere L","year":"2008","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp078026"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2008.09.011"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.010"},{"key":"e_1_2_8_9_1","volume-title":"Obstetric Fistula: A Review of Available Information","author":"Cottingham J","year":"1991"},{"key":"e_1_2_8_10_1","unstructured":"LewisG de BernisI. eds.Obstetric Fistula. Guiding Principles for Clinical Management and Programme Development.Geneva Switzerland:World Health Organization:2006. [www.who.int\/reproductive-health\/docs\/obstetric_fistula\/obstetric_fistula.pdf]. Accessed 26 October 2011."},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.033"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)15177-X"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68188-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12074"},{"key":"e_1_2_8_15_1","volume-title":"Economic Survey of Pakistan, 2004\u20135","author":"Government of Pakistan","year":"2005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.12.019"},{"key":"e_1_2_8_17_1","first-page":"525","article-title":"Obstetric fistula in rural Ethopia","volume":"84","author":"Muleta M","year":"2007","journal-title":"East Afr Med J"},{"key":"e_1_2_8_18_1","first-page":"691","volume-title":"Textbook of Female Urology and Urogynaecology","author":"Hilton P","year":"2001"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.08.008"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.08.021"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443619750114194"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.03.071"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01353.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0b013e32832ae1b7"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.12739","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.12739","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:25:51Z","timestamp":1695558351000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.12739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,31]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1111\/1471-0528.12739"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.12739","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3,31]]},"assertion":[{"value":"2013-12-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-03-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}