{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:23Z","timestamp":1787293463854,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obstetric fistula is a preventable childbirth injury that remains socially devastating for women in low-resource settings. Existing evidence on obstetric fistula stigma is largely derived from treatment centres and urban settings, leaving limited understanding of the lived experiences of women in underserved rural communities. This study addresses this knowledge gap by qualitatively examining stigma, coping strategies, and support needs among obstetric fistula survivors in Kpandai District, northern Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative exploratory descriptive design was used. Fourteen women aged 30\u201370 years who were living with obstetric fistula were recruited through purposive and snowball sampling until data saturation was reached. Semi-structured face-to-face interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's thematic analysis approach. Link and Phelan's stigma framework informed the analytic interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five themes were generated: labelling and stereotypes, separation from community, status loss and discrimination, coping mechanisms, and recommendations and support needs. Participants described name-calling, association of fistula with sin or curses, abandonment by relatives, exclusion from social and religious gatherings, and loss of social respect. Coping strategies included faith and spirituality, concealment of leakage and odour, withdrawal from public spaces, and limited psychosocial support from relatives or friends. Participants prioritised accessible fistula treatment, community education, livelihood support, and social inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obstetric fistula-related stigma extends beyond the physical injury, profoundly affecting women's social identity, dignity, and wellbeing. Comprehensive survivor-centred care that integrates surgical repair with psychosocial support, community stigma reduction, livelihood restoration, and strengthened referral systems is essential to promote successful reintegration and improve long-term health and social outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frph.2026.1923194","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:37:36Z","timestamp":1787290656000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intersecting stigma, social exclusion and coping mechanisms among women living with obstetric fistula in rural northern Ghana: a qualitative study"],"prefix":"10.3389","volume":"8","author":[{"given":"Nawara Sulemana","family":"Abilla","sequence":"first","affiliation":[{"name":"Department of Nursing, College of Nursing and Midwifery","place":["Ntotroso, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernestina","family":"Asiedua","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health, School of Nursing and Midwifery, University of Ghana","place":["Legon-Accra, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce B. P.","family":"Pwavra","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health, School of Nursing and Midwifery, University of Ghana","place":["Legon-Accra, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salamatu","family":"Issah","sequence":"additional","affiliation":[{"name":"Department of Midwifery, Nursing and Midwifery Training College- Kpembe","place":["Salaga- Savannah Region, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephraim","family":"Senkyire","sequence":"additional","affiliation":[{"name":"Department of Nursing & Midwifery, Ga West Municipal Hospital, Ghana Health Service","place":["Amasaman-Accra, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0283666","DOI":"10.1371\/journal.pone.0283666","article-title":"Awareness of obstetric fistula and its associated factors among reproductive-aged women: demographic and health survey data from Gambia","volume":"18","author":"Tweneboah","year":"2023","journal-title":"PLoS One"},{"key":"B2","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1186\/s12889-022-14107-7","article-title":"Prevalence and factors associated with the awareness of obstetric fistula among women of reproductive age in the Gambia: a multilevel fixed effects analysis","volume":"22","author":"Afaya","year":"2022","journal-title":"BMC Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e066923","DOI":"10.1136\/bmjopen-2022-066923","article-title":"Women's views on obstetric fistula risk factors and prevention in north-central Nigeria: an interpretive descriptive study","volume":"13","author":"Bulndi","year":"2023","journal-title":"BMJ Open"},{"key":"B4","first-page":"178","article-title":"A survey on obstetric fistula awareness in northern Ghana","volume":"4","author":"Saeed","year":"2014","journal-title":"\u00a0Eur J Exp Biol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1002\/ijgo.13034","article-title":"Knowledge of obstetric fistula among prenatal clinic attendees and midwives in mfantsiman municipality, Ghana","volume":"148","author":"Azanu","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"22","DOI":"10.11604\/pamj.2020.36.22.22204","article-title":"Nigeria, a high burden state of obstetric fistula: a contextual analysis of key drivers","volume":"36","author":"Bello","year":"2020","journal-title":"Pan Afr Med J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"683","DOI":"10.2147\/IJWH.S306221","article-title":"Estimating the prevalence and risk factors of obstetric Fistula in Ethiopia: results from demographic and health survey","volume":"13","author":"Gedefaw","year":"2021","journal-title":"Int J Womens Health"},{"key":"B8","volume-title":"Factors Predicting Obstetric Fistula Among Women 15\u221249 Years Old in Uganda [Dissertations and Doctoral Studies] [Internet]","author":"Fofanah","year":"2021"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e020877","DOI":"10.1136\/bmjgh-2025-020877","article-title":"Global, regional and national estimates of obstetric fistula prevalence","volume":"10","author":"Ahmed","year":"2025","journal-title":"BMJ Glob Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e064830","DOI":"10.1136\/bmjopen-2022-064830","article-title":"Health-seeking experiences of women with obstetric fistula: a qualitative study at two fistula centres in Ghana","volume":"13","author":"Asiedua","year":"2023","journal-title":"BMJ Open"},{"key":"B11","year":"2018"},{"key":"B12","year":"2024"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/S0140-6736(06)69476-2","article-title":"Obstetric vesicovaginal fistula as an international public-health problem","volume":"368","author":"Wall","year":"2006","journal-title":"Lancet"},{"key":"B14","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s12905-018-0605-1","article-title":"Consequences of obstetric fistula in sub Sahara African countries, from patients' perspective: a systematic review of qualitative studies","volume":"18","author":"Bashah","year":"2018","journal-title":"BMC Women's Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1080\/10911359.2021.1875099","article-title":"Suffering yet surviving: narratives of women living with obstetric fistula in the northern region of Ghana","volume":"32","author":"Dako-Gyeke","year":"2022","journal-title":"J Hum Behav Soc Environ"},{"key":"B16","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s41134-022-00209-0","article-title":"Are we human beings like others? 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