{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:34:52Z","timestamp":1777944892435,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Obstetric fistula, a preventable consequence of prolonged obstructed labor, inflicts profound physical, psychological, and social suffering, leaving many women described as \u201cliving dead.\u201d In Ethiopia, where the burden remains high, little is known about women lived experiences and coping strategies beyond clinical outcomes. This review was conducted to synthesize qualitative evidence, illuminate these challenges, and inform holistic interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To synthesize available evidence on the lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This study employed a qualitative meta-synthesis approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods:<\/jats:title>\n                    <jats:p>This review was conducted in accordance with the Joanna Briggs Institute systematic review and meta-synthesis methodological guidance and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. ATLAS.ti software, Version 25, Lumivero was used for analysis. A comprehensive literature search was performed across multiple databases up to May 25, 2025, including both published and unpublished studies examining the lived experiences of women with obstetric fistula. All eligible studies were critically appraised using the Critical Appraisal Skills Program to ensure methodological rigor. Data were systematically extracted and analyzed using thematic synthesis, and the results are presented through tables, narrative summaries, and illustrative diagrams, providing a coherent and evidence-based synthesis of women\u2019s experiences and coping mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eight studies met the inclusion criteria, encompassing the diverse experiences of women with obstetric fistula in Ethiopia. Four major themes were developed: physical challenges such as pain, foot drop, odor, and urinary incontinence; psychological challenges including hopelessness, grief, and suicidal ideation; socioeconomic challenges like stigma, isolation, divorce, loneliness, social disintegration, and economic difficulties; and coping mechanisms such as self-isolation and wearing multiple layers of clothing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Women with obstetric fistula face intersecting physical, psychological, and socioeconomic burdens that erode dignity and social participation. Coping strategies such as self-isolation and layering clothes, while adaptive, often reinforce stigma and exclusion. These findings highlight the need for comprehensive interventions that go beyond surgical repair to include psychosocial support, stigma reduction, and economic reintegration programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>Registered with PROSPERO 2025 CRD420251064015.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251411072","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:50:18Z","timestamp":1767358218000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The lived experiences and coping mechanisms of women with obstetric fistula in Ethiopia: A systematic review and meta-synthesis of qualitative evidence"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2131-6591","authenticated-orcid":false,"given":"Yonas","family":"Abebe","sequence":"first","affiliation":[{"name":"Department of Midwifery, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diriba","family":"Bekele","sequence":"additional","affiliation":[{"name":"Institute of Health, School of Nursing, Wollega University, Nekemte, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robera","family":"Demissie","sequence":"additional","affiliation":[{"name":"Institute of Health, School of Nursing, Wollega University, Nekemte, Ethiopia"},{"name":"Ingraham School of Nursing, McGill University, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.14.141473"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.009"},{"key":"e_1_3_3_4_2","volume-title":"Guiding Principles for Clinical Management and Programme Development: Obstetric Fistula","author":"World Health Organization","year":"2005","unstructured":"World Health Organization. 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