Background:

Obstetric fistula is a major public health problem in low-income countries. It is also one of the most severe childbirth injuries that occur when labor is allowed to progress for a period lasting from several days to a week without timely medical intervention, usually a cesarean section (1).

Vesicovaginal fistula (VVF) is abnormal communication between the two epithelial surface of vagina and the bladder that causes constant, uncontrollable urine incontinence (2). This fistula are uncommon in developed nations and are mostly caused by radiation therapy, malignant illness, and surgical trauma to the bladder during a hysterectomy (2,3). On the other hand, VVF are prevalent issues that affect a lot of women in the developing nations of Africa and south Asia. Long-term obstructed labor is the main cause of fistulas in these nations (4).

In Tanzania alone, there are up to 21,400 women currently living with untreated fistula and each year an estimated 3000 women develop new OF. The data from the Global Fistula Map for 2015 show that the number of surgeries performed on fistula patients in Tanzania amount to approximately 800 per year (5)
Study was done in two hospitals in Tanzania in young girls, the perceived socioeconomic and health system causes of obstetric fistula fundamentally reflected the challenges faced by women at home, on their way to an adequate health facility, and the subsequent poor quality of obstetric care women received at healthcare facilities (1)

Obstetric fistula patients experience significantly higher symptoms of depression, posttraumatic stress disorder, somatic complaints, maladaptive coping and significantly lower social support (6).

They coped with the incontinence in various ways among which some were non effective and might have continuing negative impact on woman’s quality of life even after corrective surgery (7).

Delay in seeking treatment for obstetric fistula was related to inadequate knowledge about the causes and treatment of obstetric fistula, distance and transport cost to a health facility, stigma, community isolation, social isolation and use of traditional and cultural (8).

It has been observed that factors enhancing poor seeking care behavior was due to lack of permission from husband/family, no knowledge that repair services exist, psychological depression, societal stigmatization, transportation challenges, money for the treatment, myths and misconception on obstetric fistula and poor health systems (9).

This study is aimed to assess the risk factors associated with the occurrence of VVF among patients admitted to the gynecological ward at Bugando Medical Centre (BMC) in which most of risk factors in our setting are increasingly recognized as conditions that are both preventable and treatable, often with simple and inexpensive interventions.