{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:15:30Z","timestamp":1787505330032,"version":"build-2736575974"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2019,12]]},"DOI":"10.1186\/s12905-019-0781-7","type":"journal-article","created":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T10:03:21Z","timestamp":1561975401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["The loss of dignity: social experience and coping of women with obstetric fistula, in Northwest Ethiopia"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6631-1368","authenticated-orcid":false,"given":"Debrework Tesgera","family":"Bashah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebaw Gebeyehu","family":"Worku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mezgebu","family":"Yitayal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telake","family":"Azale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,7,1]]},"reference":[{"key":"781_CR1","doi-asserted-by":"publisher","first-page":"60","DOI":"10.2471\/BLT.14.141473","volume":"93","author":"T \u00d6zge","year":"2015","unstructured":"\u00d6zge T, Vandana T, Evelyn L, Cynthia KS, Saifuddin A. Measuring the incidence and prevalence of obstetric fistula: approaches, needs and recommendations. Bull World Health Organ. 2015;93:60\u20132.","journal-title":"Bull World Health Organ"},{"key":"781_CR2","unstructured":"Ryan F. The typical story of obstetric fistula : the need to enhance awareness, action & funds. 2014(17)."},{"key":"781_CR3","unstructured":"Almaw TF, Keysers L, and, Chhachhi A. From trauma to rehabilitation and reintegration: experiences of women facing the challenges of obstetric fistula in Addis Ababa, Ethiopia. November,2010."},{"key":"781_CR4","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ijgo.2008.09.011","volume":"104","author":"A Zhengx","year":"2008","unstructured":"Zhengx A, Frank W, Ander J. Obstatric fistula in low income countries. Int J Gyneacol Obstat. 2008;104:85\u20139.","journal-title":"Int J Gyneacol Obstat"},{"issue":"Suppl 1","key":"781_CR5","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.ijgo.2007.06.009","volume":"99","author":"S Ahmed","year":"2007","unstructured":"Ahmed S, Genadry R, Stanton C, Lalonde A. Dead women walking: neglected millions with obstetric fistula. Int J Gynecol Obstet. 2007;99(Suppl 1):S1\u20133.","journal-title":"Int J Gynecol Obstet"},{"key":"781_CR6","first-page":"1","volume":"41","author":"F Kalembo","year":"2012","unstructured":"Kalembo F, Zgambo M. Obstetric fistula: a hidden public health problem in sub-Saharan Africa. Arts Soc Sci J. 2012;41:1\u20138.","journal-title":"Arts Soc Sci J."},{"key":"781_CR7","unstructured":"Abrams P, Ridder Dd, deVries C, Sohier Elneil, Esegbona G, Mourad S, et al. Obstetric fistula in the developing world. ICUD (international consultation on urological diseases). 2010:1-7."},{"key":"781_CR8","doi-asserted-by":"crossref","unstructured":"Tarekegn SM, Lieberman LS, and, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian demographic and health survey. BMC Pregnancy Childbirth. 2014;14(161):1\u201313.","DOI":"10.1186\/1471-2393-14-161"},{"key":"781_CR9","unstructured":"Women\u2019s Dignity Project and EngenderHealth T. Reducing the Risk of Obstetric Fistula: Skilled Birth Attendance and Emergency Obstetric Care. 2006:1-13."},{"key":"781_CR10","unstructured":"Lilian T, and, Thecla W. Living with constant leaking of urine and odour: thematic analysis of socio-cultural experiences of women affected by obstetric fistula in rural Tanzania. BMC Womens Health. 2015;15(107):1\u20139."},{"issue":"2","key":"781_CR11","first-page":"54","volume":"2","author":"M Kabir","year":"2004","unstructured":"Kabir M, Iliyasu Z, Abubakar I, Umar U. medico-social problems of patients with vesico-vaginal fistula in Mutala Mohammed specialist Hospital, Kano. Ann Afr Med. 2004;2(2):54\u20137.","journal-title":"Ann Afr Med"},{"key":"781_CR12","doi-asserted-by":"crossref","unstructured":"Kayondo M, Wasswa S, Kabakyenga J, Mukiibi N, Jude S, Stenson A, et al. Predictors and outcome of surgical repair of obstetric fistula at a regional referral hospital, Mbarara, western Uganda. 2011;11(23):1-9. \n                    www.ncbi.nlm.nih.gov\/pubmed\/22151960\n                    \n                  .","DOI":"10.1186\/1471-2490-11-23"},{"issue":"1","key":"781_CR13","first-page":"229","volume":"3","author":"J Mutambra","year":"2013","unstructured":"Mutambra J, Maunganidze L, Muchichewa P. Towards promotion of maternal health: the psychological impact of obstetric fistula on wumen in Zimbabwe. Int J Asian Soc Sci Towards Promotion Mat Health. 2013;3(1):229\u201339.","journal-title":"Int J Asian Soc Sci Towards Promotion Mat Health"},{"key":"781_CR14","unstructured":"Ahmad KM, Sharifi K, and, Bahram AA. Prevalence of obstetric fistula among women of reproductive age in six provinces of Afghanistan,. Social and health development program (SHDP) 2011."},{"key":"781_CR15","doi-asserted-by":"crossref","unstructured":"Browning A, Fentahun W, Goh J. The impact of surgical treatment on the mental health of women with obstetric fistula. 2007;114(11):1439\u201341. \n                    https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17903234\n                    \n                  .","DOI":"10.1111\/j.1471-0528.2007.01419.x"},{"issue":"2","key":"781_CR16","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.ijgo.2004.05.003","volume":"86","author":"A Browning","year":"2004","unstructured":"Browning A, Patel T. FIGO initiative for the prevention and treatment of vaginal fistula. Int J Gynaecol Obstet. 2004;86(2):317\u201322.","journal-title":"Int J Gynaecol Obstet"},{"issue":"8","key":"781_CR17","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1080\/17441692.2010.551519","volume":"6","author":"P Rachel","year":"2011","unstructured":"Rachel P, Maggie B. Jennifer HR. restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania. Glob Public Health. 2011;6(8):859\u201387.","journal-title":"Glob Public Health"},{"issue":"2","key":"781_CR18","first-page":"121","volume":"3","author":"BK Gulati","year":"2011","unstructured":"Gulati BK, Unisa S, Pandey A, Sahu D, Ganguly S. Correlates of occurrence of obstetric fistula among women in selected states of India: an analysis of DLHS1-3 data. OBGYN. 2011;3(2):121\u20138.","journal-title":"OBGYN"},{"issue":"2","key":"781_CR19","first-page":"121","volume":"3","author":"B Gulati","year":"2011","unstructured":"Gulati B, Unisa S, Pandey A, Sahu D, Ganguly S. Correlates of occurrence of obstetric fistula among women in selected states of India: an analysis of DLHS1-3 data. OBGYN. 2011;3(2):121\u20138.","journal-title":"OBGYN."},{"key":"781_CR20","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s00192-010-1236-8","volume":"22","author":"M Bangser","year":"2011","unstructured":"Bangser M, Manisha M, Janet S, Chris D, Catherine K, et al. Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. Int Urogynecol J. 2011;22:91\u20138.","journal-title":"Int Urogynecol J"},{"key":"781_CR21","unstructured":"Tebeua P-M, Bernis L, Boisrondd L, Duke A, and, al. e. Knowledge, attitude and perception about obstetric fistula by Cameroonian women. A clinical survey conducted in Maroua, capital of the far north province of Cameroon. Prog Urol. 2008;18:379\u2013389."},{"key":"781_CR22","unstructured":"Yifru B, and, Asres B. Reasons for persistently high maternal and perinatal mortalities in Ethiopia. 2008."},{"issue":"49","key":"781_CR23","first-page":"1","volume":"11","author":"LT Mselle","year":"2011","unstructured":"Mselle LT, Karen MM, Bj\u00f8rg E-O, Abu M, Thecla WK. \u201cI am nothing\u201d: experiences of loss among women suffering from severe birth injuries in Tanzania. BMC Womens Health 2011;11(49):1\u201312.","journal-title":"BMC Womens Health"},{"issue":"12","key":"781_CR24","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. Br J Obstet Gynaecol. 2008;115(12):1564\u20139.","journal-title":"Br J Obstet Gynaecol"},{"issue":"17","key":"781_CR25","first-page":"150","volume":"2","author":"K Donnelly","year":"2015","unstructured":"Donnelly K, Oliveras E, Yewondwossen T, Belachew M, Mengistu A. The quality of life of Ethiopian women after fistula repair: implications on rehabilitation and social reintegration policy and programming. Int J Res, Interv Care. 2015;2(17):150\u201364.","journal-title":"Int J Res, Interv Care."},{"issue":"1","key":"781_CR26","doi-asserted-by":"publisher","first-page":"28","DOI":"10.12968\/ajmw.2012.6.1.28","volume":"6","author":"M S\u00f6derb\u00e4ck","year":"2012","unstructured":"S\u00f6derb\u00e4ck M, Wilhelmsson E, H\u00e4ggstr\u00f6m-Nordin E. Absence and reliance:Liberian women's experience of vaginal fistula. Afr J Midwifery Womens Health. 2012;6(1):28\u201334.","journal-title":"Afr J Midwifery Womens Health"},{"issue":"40","key":"781_CR27","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0968-8080(12)40661-9","volume":"20","author":"AM Khisa","year":"2012","unstructured":"Khisa AM. Nyamongo IK. Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in west Pokot, Kenya. Reprod Health Matters. 2012;20(40):59\u201366.","journal-title":"Reprod Health Matters"},{"issue":"3","key":"781_CR28","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1525\/maq.2006.20.3.345","volume":"20","author":"M Inhorn","year":"2006","unstructured":"Inhorn M. Defining women's health: a dozen messages from more than 150 ethnographies. Med Anthropol Q. 2006;20(3):345\u201378.","journal-title":"Med Anthropol Q"},{"key":"781_CR29","doi-asserted-by":"crossref","unstructured":"Okoye UO, Emma-Echiegu N. And, Tanyi PL. living with vesico-vaginal fistula: experiences of women awaiting repairs in Ebonyi state, Nigeria. Tanzania J Health Res. 2014;16(4).","DOI":"10.4314\/thrb.v16i4.9"},{"key":"781_CR30","first-page":"294","volume":"29","author":"MA Ijaiya","year":"2010","unstructured":"Ijaiya MA, Rahman AG, Aboyeji AP, Olatinwo AW, Esuga SA, Ogah OK, et al. Vesico-vaginal fistula: a review of Nigerian experience. West Afr J Med. 2010;29:294\u20138.","journal-title":"West Afr J Med"},{"key":"781_CR31","first-page":"259","volume":"4","author":"EY Mohamed","year":"2009","unstructured":"Mohamed EY, Boctor MF, Ahmed HA, Seedahmed H, Abdelgadir MA. Et al. contributing factors of vesico-vaginal fistula (VVF) among fistula patients in Dr. Abbo's National Fistula & Urogynecology Centre - Khartoum. Sudanese J Public Health. 2009;4:259\u201364.","journal-title":"Sudanese J Public Health"},{"issue":"6","key":"781_CR32","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1080\/07399332.2012.755981","volume":"34","author":"PP Mwini-Nyaledzigbor","year":"2013","unstructured":"Mwini-Nyaledzigbor PP, Agana A, Beryl F. Lived experiences of Ghanaian women with obstetric fistula. Health Care Women Int. 2013;34(6):440\u201360.","journal-title":"Health Care Women Int"},{"issue":"2","key":"781_CR33","first-page":"055","volume":"2","author":"SB Baba","year":"2014","unstructured":"Baba SB. Birth and sorrow: the psycho-social and medical consequences of obstetric fistula. Int J Medical Sociol Anthropol. 2014;2(2):055\u201365.","journal-title":"Int J Medical Sociol Anthropol"},{"issue":"2","key":"781_CR34","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1080\/17441692.2010.491833","volume":"6","author":"M Yeakey","year":"2011","unstructured":"Yeakey M, Chipeta E, Rijken Y, Taulo F, Tsui A. Experiences with fistula repair surgery among women and families in Malawi. Glob Public Health. 2011;6(2):153\u201367.","journal-title":"Glob Public Health"},{"key":"781_CR35","unstructured":"Bonnie JR. Shattered lives: understanding obstetric fistula in Uganda: Oregon State University; 2012."},{"issue":"8","key":"781_CR36","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1080\/17441692.2010.551519","volume":"6","author":"R Pope","year":"2011","unstructured":"Pope R, Bangser M. JH. R. Restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania. Global Public Health. 2011;6(8):859\u201373.","journal-title":"Global Public Health"},{"key":"781_CR37","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1080\/01443610903100609","volume":"29","author":"E Gharoro","year":"2009","unstructured":"Gharoro E, Agholor K. Aspects of psychosocial problems of patients with vesico-vaginal fistula. Obstet Gynaecol. 2009;29:644\u20137.","journal-title":"Obstet Gynaecol"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-019-0781-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12905-019-0781-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-019-0781-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T19:08:58Z","timestamp":1593457738000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-019-0781-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,1]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["781"],"URL":"https:\/\/doi.org\/10.1186\/s12905-019-0781-7","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,1]]},"assertion":[{"value":"26 September 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 June 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical clearance was obtained from theInstitutional Review Board of University of Gondar (ref number: O\/V\/P\/RCS\/05\/935\/2016) and permission was obtained from Chief Clinical DirectorateOffice of the Gondar Specialized Referral Hospital and from the fistula center coordinating office. Prior to interview an information sheet was read to the study participants to explain the purpose of the research, procedure and associated emotional risk of talking all their difficulties. Also they were informed that participation is voluntary, they do have the right to withdraw from the study at any time without any form of prejudice. Respondents were told the attainment of confidentiality and the information they give will not be used for any purpose other than study and their name and\/or hospital number or any identifications which refer to them was not recorded. Therefore, codes were assigned and potentially identifying details were changed. They were interviewed in separate room keeping their privacy. The study was interview based and reports are based on cumulative result. After assessing the proposal document the ethical review committee has identified the study procedure to cause less than very minimal risk and therefore, verbal consent was obtained from each woman for both participation and audio recording.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"84"}}