Knowledge of obstetric fistula and associated Factors among reproductive age women in Chelia District, West Shoa Zone, Oromia Region, Ethiopia A community based cross-sectional study

Knowledge of obstetric fistula and associated Factors among reproductive age women in Chelia District, West Shoa Zone, Oromia Region, Ethiopia A community based cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge of obstetric fistula and associated Factors among reproductive age women in Chelia District, West Shoa Zone, Oromia Region, Ethiopia A community based cross-sectional study Girma Lechisa Shanko, Temesgen Daksisa Buli, Tsegaye Benti Muse This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5052009/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Obstetric fistula is a hole between vagina and rectum or bladder that leads to continuous leakage of urine and/or feces.Globally, approximately 50,000-100,000 women develop fistulas annually, and approximately 2 million currently live with fistulas, which is a burden in almost 60 countries and continues to be a neglected public health problem. Ethiopia is a developing country with poor maternal healthcare and high prevalence of obstetric fistulas. Objective: This study aimed to assess knowledge of obstetric fistula and associated factors among women of reproductive age in Chelia district, WesternEthiopia, in 2021. Methods: Community-based cross-sectional study was conducted among 403 participants who were randomly selected and enrolled between September 25 and October 30, 2021. Pretested and structured questionnaires were used to collect data. Bivariable and multivariable logistic regression analyses were performed to identify associated factors. Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p-value of < 0.05. Results: This study showed that 20.2% (95% confidence interval: 12.6-27.7) of reproductive age women had a good knowledge of obstetric fistula . Independent variables such as living in urban (AOR=2.93:95% confidence interval:1.59-5.39), educational attainment of more than secondary (AOR =4.82:95% confidence interval:1.56-14.87), institutional delivery (AOR=2.21:95% confidence interval: 1.27-3.84), contraceptive use(AOR=2.95:95% confidence interval:1.23-7.06) and having prior information on obstetric complications (AOR =3.14:95% confidence interval:1.52-6.51) were found to be significantly associated with knowledge of obstetric fistula. Conclusions and Recommendations: This study showed that awareness of obstetric fistulas is low. Residence, educational status, institutional delivery, contraceptive use, and prior information on obstetric complications were significantly associated with awareness of obstetric fistulas. Therefore, special attention should be paid to the identified factors of maternal healthcare issues, particularly obstetric fistulas. Obstetric fistula knowledge reproductive age women Chelia Oromia Figures Figure 1 Introduction An obstetric fistula is an abnormal connection between the vagina, rectum, and bladder that may develop after prolonged and obstructed labor and lead to continuous urinary or fecal incontinence ( 1 ). The commonest type of obstetric fistula is vesico-vaginal fistula (VVF) which accounts 79% of cases but there is also cases of recto vaginal fistula (RVF) 1–8% and combined (VVF and RVF) 1–23%. Both lead to uncontrolled leakage of urine and feces( 2 ). This problem is caused by direct causes such as prolonged obstructed labor, early childbearing, early marriage, and Female Genital Mutilation (FGM), and indirect risk factors such as illiteracy, poverty, and low economic status of women, which increases the incidence of obstetric fistula( 3 ). In areas where the most challenging barriers that prevent women from seeking care include various barriers in accessing health care, lack of awareness to recognize pregnancy and labor complications, powerlessness to seek care, low expectation of care, and desire to further undermine the timeline and quality of care they receive, they often continue to suffer from obstetric fistula for years or decades( 6 ). Strategies for the prevention of obstetric fistulas include delaying the age of first birth, cessation of harmful traditional procedures, and prompt access to obstetric care. Obstetric fistula prevention and management help achieve Sustainable Development Goal 3 to improve maternal health( 7 ). Globally, approximately 50,000–100,000 women develop obstetric fistulas annually, with at least 33,000 reported from sub-Saharan Africa (SSA)( 9 ) and approximately 2 million women currently living with fistulas, which is a burden in almost 60 countries, including Ethiopia. Although preventable and virtually nonexistent in developed countries, fistulas continue to affect many poor women and girls worldwide. Obstetric fistulas have been eliminated in developed countries but remain highly prevalent in SSA( 5 ). In developing countries, where fertility is high and obstetric services are poor, obstetric complications are the predominant risk factor for fistula occurrence. Women who sustain obstetric fistulas commonly suffer from secondary ailments, such as foot drop, bladder and kidney infections, limb contractures, or excoriation of the skin from constant exposure to urine or feces. Obstetric fistulas are extremely rare in resource-rich countries and affect an estimated one million women in the global south, most of whom live in SSA( 10 ). Ethiopia is among the countries with a high prevalence of untreated obstetric fistula, with an estimated incidence of 3,500 new cases per year and a prevalence of 37,500 untreated fistula( 12 ). Currently, the prevalence of obstetric fistulas in Ethiopia is 4 per 1000 reproductive age women (0.4%). Regionally wise, percentage of reproductive age women who had ever heard of obstetric fistulas was lower in Oromia region (28.6%) than Tigray (65.8%) and Amhara regions (45%) ( 13 ). The potential consequences for women with fistulas are social, emotional, and physical. The most obvious sequela is incontinence, either urinary, fecal, or both, which is linked to social and economic exclusions, which in turn leads to high risks of depression, social stigma, and marginalization from their families and communities, resulting in suicide( 4 , 14 ). Furthermore, sociocultural issues such as early marriage, harmful cultural practices such as female genital mutilation(FGM), home-based childbirth, poor policy implementation of female education, and misconceptions about childbirth practices are other contributing factors to the high burden of obstetric fistula in SSA( 16 ). Once an obstetric fistula occurs, the difficulty that fistula patients experience is enormous and unbearable, despite the fact that very little has been done to address this issue( 11 ). A lack or low level of awareness of obstetric fistulas is one of the most challenging barriers preventing women from seeking care. Fistula is a problem until the world does something to end. It is believed that once someone learns about a condition, they refuse to accept its existence( 3 ). Thus, this study aimed to assess the awareness of obstetric fistulas and associated factors among women of reproductive age in the study area( 17 ). Methods Study design, setting and population A community-based cross-sectional study was conducted in the Chelia district, West Shoa zone, Oromia regional state, western Ethiopia, from September 25 to October 30, 2021. One of the 22 districts in the western shoa zone is 178 km from Addis Ababa, the capital city of Ethiopia. The district has 3 urban and 18 rural kebeles (the lowest administrative unit in Ethiopia). The district has one General Hospital, four primary healthcare units, ten private clinics, and five drugstores ( 17 ). All women in the reproductive age group (15–49 years of age) in the selected kebeles were the study population. Randomly selected women in the reproductive age group (15–49 years of age) were included in the study. However, women of reproductive age who were health professionals or related working in health and health-related fields, those unable to respond to the interview because of being critically ill, and those who had suffered or were currently suffering from obstetric fistulas were excluded from the study. Sample size determination The sample size was calculated by using a single-population formula. Hence, for the first objective, assuming an assumption of 95% confidence interval, 5% margin of error, 40.8% proportion of reproductive age women’s awareness in Bench Sheko zone, Southwest Ethiopia ( 21 ), and 10% non-response rate as follows: \(\:\) \(\:n=\frac{({Z\alpha\:/2)}^{2}*P\left(1-P\right)}{{d}^{2}}\) $$\:n=\frac{({1.96)}^{2}*0.408\left(1-0.408\right)}{{\left(0.05\right)}^{2}}$$ By adding 10% non-response rates, the sample size calculated for the first objective was 408. Sampling procedure and Sampling Technique A simple random sampling technique was used to select participants from 2 urban and 6 rural kebeles. The lists of households with eligible women of reproductive age were prepared from family folders (registration books) found at health posts in collaboration with health extension workers and were used as a sampling frame. The lottery method was used when there were two or more eligible women of reproductive age in one household. The sample size was then proportionally allocated to all selected smallest administrative units according to their population size, and a computer-generated table of random numbers of a simple random sampling technique was employed to select eligible women of reproductive age. Finally, the selected reproductive-aged women were interviewed using data collectors at their homes. Reproductive-aged women who were absent on the first day were revisited for the second time, and absentees after two repeated visits were taken as non-respondents. Study variables In this study, awareness of obstetric fistulas was an outcome variable, whereas socioeconomic characteristics, reproductive or obstetry-related factors, and health-facility-related factors were independent predictors. Operational definition Awareness: - Awareness is the state of being conscious of something. Knowledge on obstetric fistula According to this study, knowledge of obstetric fistula refers to the awareness of risk factors, symptoms, and prevention of obstetric fistula. Good knowledge Participants who scored above or equal to the mean score were considered to have a good awareness. Poor knowledge Participants who scored lower than the mean were considered to have poor awareness. The awareness level was categorized into two groups by calculating the mean. Those who scored above or equal to the mean score were considered to have good awareness, whereas those who scored below the mean score were considered to have poor awareness( 20 , 21 ). Data collection tools and technique The structured interviewer-administered questionnaire was adapted from previous literatures( 20 , 21 ). The data collection tool was arranged into sections on sociodemographic and cultural-related characteristics, reproductive and obstetric-related questions, health institution-and service provider-related factors, and awareness of obstetric fistula-related questions. It was initially prepared in English, translated into Afan Oromo, and then translated back into English to maintain its consistency and accuracy. The Afan Oromo version of the questionnaire was used for the data collection. Data were collected by four trained clinical nurses and the data collection process was supervised by two Health Officers and a principal investigator during the data collection period. Data quality control and management Before data collection, data collectors and supervisors provided one day of training on the objective of the study, the data collection procedure, completeness of the data, and ethical considerations during data collection. Before starting the actual survey in the district, the tool was pretested on 5% ( 21 ) of the calculated sample size of the smallest administrative units not selected in the study. After pretesting, necessary modifications were considered. A clear explanation of the purpose and objective of the study was provided to all respondents before beginning the interviews. Close supervision was carried out by the supervisors and the principal investigator during data collection at each site. All the completed questionnaires were checked for completeness and accuracy before data entry. Data processing and analysis Data were checked for completeness, coded, entered into a computer using Epi-Data version 3.1 and exported to SPSS version 25 for analysis. Descriptive statistics and binary logistic regression (Bi-variable and Multivariable logistic regression analyses) were performed. Model fitness and multicollinearity effects between covariates were checked. From the bi-variable logistic regression analysis, variables having P-value ≤ 0.25 were considered eligible for multivariable logistic regression analysis. Finally, adjusted odds ratios (AOR) of independent variables with their 95% confidence intervals (CIs) were estimated to identify the presence and strength of associations, and statistical significance of association was declared at p-value of < 0.05. Ethics statement Ethical clearance for the study was obtained from the Institutional Review Board of Ambo University, College of Medicine and Health Sciences. The permission and support letters were obtained from the Chelia District Health Office. The purpose and importance of the study were explained, and informed verbal consent was obtained from all the respondents. For those aged < 18 years, informed verbal assent was obtained from their guardians (caregivers). In addition, confidentiality and privacy of the study participants were assured and respected. Results Socio-demographic and cultural characteristics of the study respondents A total of 403 respondents were interviewed, yielding a response rate of 98.7%. The mean age of the respondents was 29.96 years with a standard deviation (SD) of ± 6.21. Thirty six (8.9%) of them attained more than secondary education and 177(43.9%) of husband attained primary education. In total, 303(75.2%) were rural dwellers and 368(90.2%) of them were married. 277 (68.7%) respondents decided jointly with their husband in seeking health services. majority, 343, 85.1%) of respondents were housewives by occupation. More than half, 234 (58.1%) of the participants replied as it took more than thirty minutes to reach the nearest health facility from their home (Table 1 ). Table 1 Distribution of Socio-demographic characteristics of study participants, Chelia District, West Shoa zone, Oromia region, Ethiopia, 2021 (n = 403) Variables Category Frequency Percent Age category of respondents 15–19 14 3.5 20–24 66 16.4 25–29 112 27.8 30–34 103 25.6 35–39 65 16.1 40–44 30 7.4 45–49 13 3.2 Marital status of respondents Married 365 90.6 Single 16 4 Divorced 9 2.2 Others* 13 3.2 Occupational status House wife 343 85.1 Merchant 36 8.9 Student 14 3.5 Government employee 10 2.5 Educational status of respondents No formal education 165 40.9 Primary education 153 38 Secondary education 49 12.2 More than secondary 36 8.9 Husband educational status No formal education 108 26.8 Primary education 177 43.9 Secondary education 61 15.1 More than secondary 57 14.1 Residence of respondents Rural 303 75.2 Urban 100 24.8 Health seeking decider Participant 102 25.3 Husband 24 6 Both 277 68.7 Time to reach the nearest health facility ≤ 30 minutes 169 41.9 > 30 minutes 234 58.1 Others* (Separated and Husband died) Reproductive and obstetrics related characteristics of respondents The majority, 354(87.8%) of the respondents were ever pregnant, and the mean age at first pregnancy was 21.06 with standard deviation of ± 2.72 years. Of the forty seven (69.8%) of the respondents were aged = 20 years age at first pregnancy. Twenty six (7.3%) of the respondents had experienced a history of induced abortion and, 270(76.3%) of them followed antenatal care at least once among those who gave birth in the last two years. Out Of the respondents, 60 (17%) of them ever had history of birth related complications and, 291(72.2%) of them ever heard of obstetric complications. Two hundred five (57.9%) of them gave birth at health institution with the assistance of skilled birth attendant. Out Of study respondents, 42(11.9%) experienced greater than or equal to six number of pregnancies and 22(6.21%) of them experienced history of prolonged labor. Regarding contraceptive use, 306 (75.9%) of them ever used contraceptives (Table 2 ). Table 2 Reproductive and obstetrics characteristics of the study participants, Chelia district, West Shoa zone, Oromia region, Ethiopia, 2021 Variables Category Frequency Percent Ever been pregnant(n = 403) Yes 354 87.8 No 49 12.2 Age at first pregnancy(n = 354) < 20 107 30 ≥ 20 247 69.8 Number of pregnancy(n = 354) =6 42 11.9 At least one ANC follow up for recent pregnancy(n = 354) Yes 270 76.3 No 84 23.7 Place of giving birth (n = 354) Health facility 205 57.9 Home 149 42.1 History of Prolonged labour(n = 354) Yes 22 6.2 No 332 93.8 History of induced abortion(n = 354) Yes 26 7.3 No 328 92.7 History of birth related complications(n = 354) (n = 403) Yes 60 17 No 294 83 Heard obstetric complication(n = 403) Yes 291 72.2 No 112 27.8 Contraceptive use(n = 403) Yes 306 75.9 No 97 24.1 Awareness of obstetric fistula In this study, 119(29.5%) of the study participants had ever heard of obstetric fistula. The major source of information, 75(63%), was the communication media. Out Of the respondents ever heard about obstetric fistula, those who had ever heard the risk factors, symptoms and prevention methods of obstetric fistula were,111(93.3%),116(97.5%), and 110(92.4%) respectively (Table 3 ). Table 3 Respondents’ characteristics of awareness on obstetric fistula in Chelia district, West Shoa zone, Oromia region, Ethiopia, 2021 Obstetric Fistula Frequency Percent Ever Heard obstetric fistula (n = 403) Yes 119 29.5 No 284 70.5 Source of information (multiple response) Media 75 63 Health facility 54 45.4 Family/relatives/friends 14 11.8 Ever heard the risk factors of obstetric? fistula(n = 119) Yes 111 93.3 No 8 6.7 Risk factors of obstetric fistula ever heard? (multiple response) Early marriage 80 67.2 Home delivery 71 59.7 Prolonged labour 64 53.8 Closely spaced pregnancy 44 37 Early pregnancy 26 21.8 Unsafe abortion 19 16 Sexual violence 12 10.1 Female genital mutilation 11 9.2 Ever heard symptoms of obstetric fistula? (n = 119) Yes 116 97.5 No 3 2.5 Symptoms of obstetric fistula ever heard (multiple response) Urinary incontinence 112 94.1 Fecal incontinence 62 52.1 Foul smelling vaginal discharge 18 15.1 Recurrent urinary tract infection 2 1.7 Ever heard prevention methods of obstetric fistula(n = 119) Yes 110 92.4 No 9 7.6 Prevention methods of obstetric fistula ever heard (multiple response) Giving birth at health facility 81 68.1 Delay early marriage 65 54.6 Contraceptive use 58 48.7 Antenatal care follow up 37 31.1 Delay early pregnancy 24 20.2 Avoid unsafe abortion 16 13.4 Avoid sexual violence 15 12.6 Avoid female genital mutilation 11 9.2 Knowledge of obstetric fistula The overall awareness of obstetric fistula was 20.2% (95% CI: 12.6–27.7) (Fig. 1.) Factors associated with awareness on obstetric fistula A binary logistic regression model was fitted to assess the statistical association between the different independent variables and obstetric fistula knowledge. Variables with a p-value ≤ 0.25 on bi-variable logistic regression analysis, were used in multivariable logistic regression analysis to control for potential confounding effects. Accordingly, the place of residence, educational status of respondents, respondents’ husbands’ educational status, occupational status, number of pregnancies, health-seeking deciders, place of delivery, birth attendants, contraceptive use, and having prior information about obstetric complications were found to be significantly associated with knowledge of obstetric fistula s. Multiple logistic regression models were fitted with independent variables that were associated with knowledge of obstetric fistulas using the backward stepwise (likelihood ratio) method, and its fit into the final model was checked using the Hosmer and Lemeshow goodness-of-fit test. In multivariable logistic regression analysis, residence, educational status of respondents, giving birth in health institutions, contraceptive use, and having prior information about obstetric complications were associated with knowledge of obstetric fistulas (p < 0.05). Multivariable logistic regression analysis showed that the odds of having knowledge of obstetric fistula among urban residents were 2.93 times more likely than rural residents (AOR = 2.93:95% CI: 1.59–5.39). The odds of having knowledge were 4.82 times higher among those with more than secondary level of education than among who had no formal education (AOR = 4.82:95% CI: 1.56–14.87). The odds of having knowledge were 2.21 times higher among those who gave birth in health institutions than their counterparts (AOR = 2.21:95% CI: 1.27–3.84). The odds of having knowledge was 2.95 times higher among contraceptive users than non-users of contraceptives (AOR = 2.95:95% CI:1.12–7.06) and, respondents who had prior information about obstetric complication were 3.14 times more likely to have knowledge than respondents who hadn’t have prior information about obstetric complications (AOR = 3.14:95% CI:1.52–6.51) (Table 4 ) Table 4 Bivariate and multivariate logistic regression analysis of factors associated with knowledge on obstetric fistula among reproductive age women in Chelia District, West Shoa zone, Oromia region, Ethiopia, 2021(n = 403) Category of variables Awareness on obstetric fistula COR(1) P-value AOR(1) P-value Yes (%) No (%) Place of residence Urban 54(54%) 46(46%) 4.3[2.66–6.94] 0.000 2.93[1.59–5.39] 0.001* Rural 65(21.5%) 238(78.5%) 1 1 Educational status Secondary education 19(38.8%) 30(61.2%) 2.05[1.04–4.03] 0.038 1.18[0.45–3.30] 0.734 More than secondary 23(63.9%) 13(36.1%) 5.72[2.65–12.33] 0.000 4.82[1.56–14.87] 0.006* No formal education 39(23.6%) 126(76.4) 1 1 Occupational status Merchant 19(52.8%) 17(47.2%) 3.24[1.61–6.51] 0.001 2.56[0.96–6.84] 0.060 Government employee 7(70%) 3(30%) 6.76[1.71–26.72] 0.006 0.96[0.15–5.91] 0.959 Housewife 88(25.7%) 255(74.3%) 1 1 Husband education Primary education 61(34.5%) 116(65.5%) 2.31[1.30–4.12] 0.004 0.91[0.62–1.33] 0.617* Secondary education 17(27.9%) 44(72.1%) 1.7[0.81–3.56] 0.16 0.918[0.32–2.62] 0.873 More than secondary 21(36.8%) 36(63.2%) 2.57[1.24–5.30] 0.11 1.03[0.35–3.03] 0.963 No formal education 20(18.5%) 88(81.5%) 1 1 Number of pregnancy >=6 9(21.4%) 33(78.6%) 0.603(0.26–1.37) 0.226 1.423[0.49–4.09] 0.513 < 3 43(31.2%) 95(68.8%) 1 1 Health seeking decider Participant/woman 28(27.5%) 74(72.5%) 0.53[0.21–1.33] 0.176 0.37[0.12–1.15] 0.087 Both husband and woman 81(29%) 196(71%) 0.58[0.25–1.36] 0.208 0.49[0.18–1.37] 0.172 Husband 10(41.7%) 14(58.3%) 1 1 Place of delivery Health facility 75(36.6%) 130(63.4) 2.39[1.46–3.92] 0.001 2.21[1.27–3.84 0.005* At home 29(19.5%) 120(80.5) 1 1 Birth attendant Skill birth attendant 75(37%) 130(63%) 2.12[1.17–3.83] 0.013 1.24[0.48–3.18] 0.659 Relatives 18(21.4%) 66(78.6%) 1 Contraceptive use Yes 103(34%) 203(66%) 2.57[1.43–4.62] 0.002 2.95[1.23–7.06] 0.015* No 16(16.5%) 81(83.5%) 1 1 Heard obstetric complications Yes 108(37%) 183(63%) 5.42[2.78–10.55] 0.000 3.14[1.52–6.51 0.002* No 11(9.8%) 101(90.2%) 1 1 Key: * Statistically significant at p-value < 0.05 Discussions This community-based study was carried out to assess the knowledge of obstetric fistulas and associated factors among women of reproductive age living in Chelia district, West Shoa zone, Oromia region, Ethiopia. The study showed that the factors found to have a statistically significant association with knowledge of obstetric fistula among women of reproductive age were place of residence, educational status of participants, and place of delivery, contraceptive use, and prior information about obstetric complications. The study revealed that 20.2% (95% CI=12.6-27.7) of the respondents had good knowledge of obstetric fistulas in the study area. This finding is consistent with a study conducted among reproductive age women in Ethiopia (23.2%) (19). The findings of this study are lower than studies conducted in Nigeria (57.8%)(3), Northern Ghana(45.8%)(34), and Bench Sheko Zone, Ethiopia(40.8%) (21). A possible explanation for this discrepancy may be the study setting, study participants, and sociodemographic factors. In Nigeria, the study was conducted on pregnant women who presented for routine antenatal clinic visits; therefore, the difference might be due to the study setting and participants. The study in Ghana was conducted in the age group of 17-60 years, the socio-demographic characteristics of the respondents in the study might be the reason for the difference. The study revealed that the odds of having knowledge of obstetric fistulas were significantly associated with place of residence, in which urban residents were 2.93 times more likely to have good knowledge than their rural counterparts. This finding is consistent with that reported by Burkina Faso, who found that rural residents were less likely to have better knowledge than urban residents(26). This might be explained by the fact that women residing in urban areas might have more access to information, easier accessibility to health facilities, and exposure to different sources of information in contrast to their rural counterparts. This study showed that women of reproductive age who attained more than a secondary level of education were 4.82 times more likely to have good knowledge of obstetric fistula than women who had no formal education. This finding is consistent with that of a study conducted in Southwest of Ethiopia in Ilu Aba Bor zone (24). This consistency might be by the fact that, those attending formal education have greater opportunities to get information from different reading materials than those who had no formal education. The study findings revealed that the place of giving birth was significantly associated with knowledge of obstetric fistula, as the odds of having knowledge were 2.21 times higher among those who gave birth at health institutions than among those who gave birth at home. Similarly, a study conducted in the southeastern zone of Tigray concluded that women who gave birth at health institutions were more likely to have good knowledge of obstetric fistulas than those who had experience of home delivery(28). Another study conducted in Ethiopia on the determinants of obstetric fistulas is consistent with this study(29). The consistency of this finding might be explained by the fact that with the issue of postpartum care, obstetric complications, including obstetric fistula, can be informed together as postpartum care activities. The study showed that contraceptive users were 2.95 times more likely to have knowledge of obstetric fistulas than their counterparts. Conversely, findings from the Nigerian Demographic Health cross-sectional survey to determine knowledge among reproductive-age women identified that women with a history of contraceptive use had lower odds of being aware of a fistula than those with no history of contraceptive use(16). A possible explanation for this difference might be that the study in Nigeria utilized secondary data from the Demographic Health Survey, whereas in this study, community-based data were utilized, and socio-demographic characteristic discrepancies might have contributed to the difference. The current study showed that having prior information about obstetric complications was significantly associated with knowledge of obstetric fistulas, in which the odds of having awareness of obstetric fistula was 3.14 times higher among study participants who had prior information than their counterparts . This finding is in line with that of a study conducted in the southeastern zone of Tigray, in which women with prior information on obstetric complications were more aware than their counterparts(28). This similarity might be explained by the fact that the issue of obstetric fistula can also be informed together with the dangers of pregnancy, since it is one of the childbirth complications. Conclusion and Recommendations The findings of this study showed that the knowledge of obstetric fistulas was low. Place of residence, educational status, institutional delivery, contraceptive use, and prior information about obstetric complications were found to be significantly associated with knowledge of obstetric fistulas. Therefore, healthcare providers, district health offices, zonal health offices, and policymakers are recommended to work hard on awareness creation, early identification, and management of obstetric fistulas. Additionally, consistent contraceptive use and skilled birth attendant uptake are recommended at all levels. Moreover, interested researchers are also recommended to conduct further studies with different designs, including qualitative aspects of the study, to obtain additional detailed findings. Declarations Authors’ declaration Ethics approval Ethical approval for this study was obtained from Ambo University Institutional review board with reference number of PGC/237/2021. Informed consent Verbal informed consent was obtained from legally authorized representatives before the study. Trial registration This research was conducted in the absence of any human related samples since it was not an experimental study. Thus trial registration is not applicable for this particular study. Acronyms and Abbreviations ANC, antenatal care; EDHS, Ethiopian Demographic Health Survey; FGM, Female Genital Mutilation; IEC, Information, Education, and Communication; RVF: Recto Vaginal Fistula; SPSS: Statistical Package for Social Science; SSA: Sub-Saharan Africa; VVF: Vesicovaginal fistula; WHO: World Health Organization. Authors’ contribution All authors conceived study protocol, participated in study design, analysis, report writing, and drafted the manuscript. All authors have read and approved the final manuscript. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. 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Biadgilign S, Lakew Y, Reda AA, Deribe K. A population based survey in Ethiopia using questionnaire as proxy to estimate obstetric fistula prevalence: Results from demographic and health survey. Reprod Health. 2013;10(1):1–8. Institutions TH, Zone A, West N, Beyene FY. Awareness and its Associated Factors of Obstetrics Fistula among antenatal care attendees in Injibara. 2019;1–15. Asefa Z, Amenu D, Berhe A. Awareness of Obstetric Fistula and its Associated Factors among Reproductive-age Group Women in Bench Sheko Zone , Southwest , Ethiopia . Community based Cross-Sectional Study.:1–6. Jarvis K, Richter S, Vallianatos H, Thornton L. Reintegration of Women Post Obstetric Fistula Repair: Experience of Family Caregivers. Glob Qual Nurs Res. 2017;4. Omari J, Wakasiaka S, Khisa W, Omoni G, Lavender T. Women and men’s awareness of obstetric fistula in facilities in Kisii and Nyamira Counties, Kenya. African Journal of Midwifery and Women’s Health. 2015 Jan 2; 9(1):12-6. Rundasa DN, Wolde TF, Ayana KB, Worke AF. Awareness of obstetric fistula and associated factors among women in reproductive age group attending public hospitals in southwest Ethiopia, 2021. Reprod Health. 2021;18(1). Yusufi MO, Fanning E, Bhatta MP. Determinants of obstetric fistula in Afghanistan: An analysis of the Demographic and Health Survey 2015. Int J Gynecol Obstet. 2022;2015. Banke-thomas AO, Kouraogo SF, Siribie A, Taddese HB, Mueller E. Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso : A Cross-Sectional Study. 2013;8(12):1–8. Tollosa DN, Kibret MA, Ababa A. International Journal of Medical Research. 2013;2(2):261–7. Asfaha BT. Awareness on presentation of obstetric fistula and associated factors among reproductive age women in south eastern zone of tigray , ethiopia , 2020 . cross sectional study. 2021;1–20. Asrat Atsedeweyn Andargie AD. Determinants of obstetric fistula in Ethiopia. Afri Heal Sci 2017;17(3). 2017;17(3):671–80. Rs K, Ej M. Perceived causes of obstetric fistulae from rural southern Tanzania. 2011;11(3). Wall LL. A Framework for Analyzing the Determinants of Obstetric Fistula Formation. 2012;43(4):255–72. Ahmed S, Tunçalp Ö. Burden of obstetric fistula: From measurement to action. Lancet Glob Heal [Internet]. 2015;3(5):e243–4. Available from: http://dx.doi.org/10.1016/S2214-109X(15)70105-1 Semira Defar. Awareness on obstetric fistula and its associated factors among reproductive age women in Asella town Oromia region, Ethiopia. 2018;(June). F SM. A survey on obstetric fistula awareness in Northern Ghana. Eur J Exp Biol. 2014;4(4):178–82. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5052009","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":355046484,"identity":"60c6c4ef-a4b1-428c-a240-126c9c8df2ba","order_by":0,"name":"Girma Lechisa Shanko","email":"","orcid":"","institution":"Oromia Health Bureau","correspondingAuthor":false,"prefix":"","firstName":"Girma","middleName":"Lechisa","lastName":"Shanko","suffix":""},{"id":355046485,"identity":"d37144db-f92c-4d46-8a4c-7e187eeb4d2e","order_by":1,"name":"Temesgen Daksisa Buli","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxklEQVRIiWNgGAWjYJCCwwwMFjz8DAxsJGmR4JFsIEULM1ALg8EBYrXIu599eLiwTULG+EbyswcfKhjk+cUO4NdieCbd4PDMNgkesxtp5oYzzjAYzpydQEBLQxrDYV6wlgQzad42hgSD24S09D+DaDGekf6NOC3yElBbDCRyiLTFQAJoy4xzEjwSZ96USc44I0HYL/L9acyfC8ps7Pnb07dJfKiwkeeXJmTLARhLAKxSAr9ysC0NMBb/AdyqRsEoGAWjYGQDAM/zPWK8igWLAAAAAElFTkSuQmCC","orcid":"","institution":"Ambo University","correspondingAuthor":true,"prefix":"","firstName":"Temesgen","middleName":"Daksisa","lastName":"Buli","suffix":""},{"id":355046486,"identity":"8e46cdc2-2105-4854-9391-5ac199eed775","order_by":2,"name":"Tsegaye Benti Muse","email":"","orcid":"","institution":"Ambo University","correspondingAuthor":false,"prefix":"","firstName":"Tsegaye","middleName":"Benti","lastName":"Muse","suffix":""}],"badges":[],"createdAt":"2024-09-08 09:35:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5052009/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5052009/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67369249,"identity":"19763415-ac49-4d69-ac11-b89285239f30","added_by":"auto","created_at":"2024-10-24 07:47:24","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":62750,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-5052009/v1/b4c22cabdf5fe312dc494806.png"},{"id":72084010,"identity":"e300d835-d968-4489-beba-8d5c2d4bfd27","added_by":"auto","created_at":"2024-12-21 22:16:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":961709,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5052009/v1/377e0964-840a-43e5-a7d8-cfcbd1b72d77.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge of obstetric fistula and associated Factors among reproductive age women in Chelia District, West Shoa Zone, Oromia Region, Ethiopia A community based cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAn obstetric fistula is an abnormal connection between the vagina, rectum, and bladder that may develop after prolonged and obstructed labor and lead to continuous urinary or fecal incontinence (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The commonest type of obstetric fistula is vesico-vaginal fistula (VVF) which accounts 79% of cases but there is also cases of recto vaginal fistula (RVF) 1\u0026ndash;8% and combined (VVF and RVF) 1\u0026ndash;23%. Both lead to uncontrolled leakage of urine and feces(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This problem is caused by direct causes such as prolonged obstructed labor, early childbearing, early marriage, and Female Genital Mutilation (FGM), and indirect risk factors such as illiteracy, poverty, and low economic status of women, which increases the incidence of obstetric fistula(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn areas where the most challenging barriers that prevent women from seeking care include various barriers in accessing health care, lack of awareness to recognize pregnancy and labor complications, powerlessness to seek care, low expectation of care, and desire to further undermine the timeline and quality of care they receive, they often continue to suffer from obstetric fistula for years or decades(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStrategies for the prevention of obstetric fistulas include delaying the age of first birth, cessation of harmful traditional procedures, and prompt access to obstetric care. Obstetric fistula prevention and management help achieve Sustainable Development Goal 3 to improve maternal health(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGlobally, approximately 50,000\u0026ndash;100,000 women develop obstetric fistulas annually, with at least 33,000 reported from sub-Saharan Africa (SSA)(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) and approximately 2\u0026nbsp;million women currently living with fistulas, which is a burden in almost 60 countries, including Ethiopia. Although preventable and virtually nonexistent in developed countries, fistulas continue to affect many poor women and girls worldwide. Obstetric fistulas have been eliminated in developed countries but remain highly prevalent in SSA(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn developing countries, where fertility is high and obstetric services are poor, obstetric complications are the predominant risk factor for fistula occurrence. Women who sustain obstetric fistulas commonly suffer from secondary ailments, such as foot drop, bladder and kidney infections, limb contractures, or excoriation of the skin from constant exposure to urine or feces. Obstetric fistulas are extremely rare in resource-rich countries and affect an estimated one million women in the global south, most of whom live in SSA(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEthiopia is among the countries with a high prevalence of untreated obstetric fistula, with an estimated incidence of 3,500 new cases per year and a prevalence of 37,500 untreated fistula(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Currently, the prevalence of obstetric fistulas in Ethiopia is 4 per 1000 reproductive age women (0.4%). Regionally wise, percentage of reproductive age women who had ever heard of obstetric fistulas was lower in Oromia region (28.6%) than Tigray (65.8%) and Amhara regions (45%) (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe potential consequences for women with fistulas are social, emotional, and physical. The most obvious sequela is incontinence, either urinary, fecal, or both, which is linked to social and economic exclusions, which in turn leads to high risks of depression, social stigma, and marginalization from their families and communities, resulting in suicide(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFurthermore, sociocultural issues such as early marriage, harmful cultural practices such as female genital mutilation(FGM), home-based childbirth, poor policy implementation of female education, and misconceptions about childbirth practices are other contributing factors to the high burden of obstetric fistula in SSA(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Once an obstetric fistula occurs, the difficulty that fistula patients experience is enormous and unbearable, despite the fact that very little has been done to address this issue(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA lack or low level of awareness of obstetric fistulas is one of the most challenging barriers preventing women from seeking care. Fistula is a problem until the world does something to end. It is believed that once someone learns about a condition, they refuse to accept its existence(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Thus, this study aimed to assess the awareness of obstetric fistulas and associated factors among women of reproductive age in the study area(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design, setting and population\u003c/h2\u003e \u003cp\u003e A community-based cross-sectional study was conducted in the Chelia district, West Shoa zone, Oromia regional state, western Ethiopia, from September 25 to October 30, 2021. One of the 22 districts in the western shoa zone is 178 km from Addis Ababa, the capital city of Ethiopia. The district has 3 urban and 18 rural kebeles (the lowest administrative unit in Ethiopia).\u003c/p\u003e \u003cp\u003eThe district has one General Hospital, four primary healthcare units, ten private clinics, and five drugstores (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAll women in the reproductive age group (15\u0026ndash;49 years of age) in the selected kebeles were the study population. Randomly selected women in the reproductive age group (15\u0026ndash;49 years of age) were included in the study. However, women of reproductive age who were health professionals or related working in health and health-related fields, those unable to respond to the interview because of being critically ill, and those who had suffered or were currently suffering from obstetric fistulas were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSample size determination\u003c/h2\u003e \u003cp\u003eThe sample size was calculated by using a single-population formula. Hence, for the first objective, assuming an assumption of 95% confidence interval, 5% margin of error, 40.8% proportion of reproductive age women\u0026rsquo;s awareness in Bench Sheko zone, Southwest Ethiopia (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), and 10% non-response rate as follows:\u003c/p\u003e \u003cp\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\(\\:\\)\u003c/span\u003e \u003c/span\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\(\\:n=\\frac{({Z\\alpha\\:/2)}^{2}*P\\left(1-P\\right)}{{d}^{2}}\\)\u003c/span\u003e \u003c/span\u003e \u003cdiv id=\"Equa\" class=\"Equation\"\u003e \u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:n=\\frac{({1.96)}^{2}*0.408\\left(1-0.408\\right)}{{\\left(0.05\\right)}^{2}}$$\u003c/div\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003eBy adding 10% non-response rates, the sample size calculated for the first objective was 408.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSampling procedure and Sampling Technique\u003c/h2\u003e \u003cp\u003eA simple random sampling technique was used to select participants from 2 urban and 6 rural kebeles. The lists of households with eligible women of reproductive age were prepared from family folders (registration books) found at health posts in collaboration with health extension workers and were used as a sampling frame. The lottery method was used when there were two or more eligible women of reproductive age in one household. The sample size was then proportionally allocated to all selected smallest administrative units according to their population size, and a computer-generated table of random numbers of a simple random sampling technique was employed to select eligible women of reproductive age. Finally, the selected reproductive-aged women were interviewed using data collectors at their homes. Reproductive-aged women who were absent on the first day were revisited for the second time, and absentees after two repeated visits were taken as non-respondents.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStudy variables\u003c/h2\u003e \u003cp\u003eIn this study, awareness of obstetric fistulas was an outcome variable, whereas socioeconomic characteristics, reproductive or obstetry-related factors, and health-facility-related factors were independent predictors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eOperational definition\u003c/h2\u003e \u003cp\u003e \u003cb\u003eAwareness: -\u003c/b\u003eAwareness is the state of being conscious of something.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eKnowledge on obstetric fistula\u003c/strong\u003e \u003cp\u003eAccording to this study, knowledge of obstetric fistula refers to the awareness of risk factors, symptoms, and prevention of obstetric fistula.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eGood knowledge\u003c/strong\u003e \u003cp\u003eParticipants who scored above or equal to the mean score were considered to have a good awareness.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePoor knowledge\u003c/strong\u003e \u003cp\u003eParticipants who scored lower than the mean were considered to have poor awareness. The awareness level was categorized into two groups by calculating the mean. Those who scored above or equal to the mean score were considered to have good awareness, whereas those who scored below the mean score were considered to have poor awareness(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection tools and technique\u003c/h2\u003e \u003cp\u003eThe structured interviewer-administered questionnaire was adapted from previous literatures(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The data collection tool was arranged into sections on sociodemographic and cultural-related characteristics, reproductive and obstetric-related questions, health institution-and service provider-related factors, and awareness of obstetric fistula-related questions. It was initially prepared in English, translated into Afan Oromo, and then translated back into English to maintain its consistency and accuracy. The Afan Oromo version of the questionnaire was used for the data collection. Data were collected by four trained clinical nurses and the data collection process was supervised by two Health Officers and a principal investigator during the data collection period.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData quality control and management\u003c/h2\u003e \u003cp\u003eBefore data collection, data collectors and supervisors provided one day of training on the objective of the study, the data collection procedure, completeness of the data, and ethical considerations during data collection. Before starting the actual survey in the district, the tool was pretested on 5% (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) of the calculated sample size of the smallest administrative units not selected in the study. After pretesting, necessary modifications were considered. A clear explanation of the purpose and objective of the study was provided to all respondents before beginning the interviews. Close supervision was carried out by the supervisors and the principal investigator during data collection at each site. All the completed questionnaires were checked for completeness and accuracy before data entry.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eData processing and analysis\u003c/h2\u003e \u003cp\u003eData were checked for completeness, coded, entered into a computer using Epi-Data version 3.1 and exported to SPSS version 25 for analysis. Descriptive statistics and binary logistic regression (Bi-variable and Multivariable logistic regression analyses) were performed. Model fitness and multicollinearity effects between covariates were checked. From the bi-variable logistic regression analysis, variables having P-value\u0026thinsp;\u0026le;\u0026thinsp;0.25 were considered eligible for multivariable logistic regression analysis. Finally, adjusted odds ratios (AOR) of independent variables with their 95% confidence intervals (CIs) were estimated to identify the presence and strength of associations, and statistical significance of association was declared at p-value of \u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthics statement\u003c/h2\u003e \u003cp\u003e Ethical clearance for the study was obtained from the Institutional Review Board of Ambo University, College of Medicine and Health Sciences. The permission and support letters were obtained from the Chelia District Health Office. The purpose and importance of the study were explained, and informed verbal consent was obtained from all the respondents. For those aged\u0026thinsp;\u0026lt;\u0026thinsp;18 years, informed verbal assent was obtained from their guardians (caregivers). In addition, confidentiality and privacy of the study participants were assured and respected.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic and cultural characteristics of the study respondents\u003c/h2\u003e \u003cp\u003eA total of 403 respondents were interviewed, yielding a response rate of 98.7%. The mean age of the respondents was 29.96 years with a standard deviation (SD) of \u0026plusmn;\u0026thinsp;6.21. Thirty six (8.9%) of them attained more than secondary education and 177(43.9%) of husband attained primary education. In total, 303(75.2%) were rural dwellers and 368(90.2%) of them were married. 277 (68.7%) respondents decided jointly with their husband in seeking health services. majority, 343, 85.1%) of respondents were housewives by occupation. More than half, 234 (58.1%) of the participants replied as it took more than thirty minutes to reach the nearest health facility from their home (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of Socio-demographic characteristics of study participants, Chelia District, West Shoa zone, Oromia region, Ethiopia, 2021 (n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003eAge category of respondents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status of respondents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e365\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eOccupational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHouse wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernment employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEducational status of respondents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHusband educational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidence of respondents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHealth seeking decider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHusband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e277\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTime to reach the nearest health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;30 minutes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003eOthers*\u003c/b\u003e (Separated and Husband died)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eReproductive and obstetrics related characteristics of respondents\u003c/h2\u003e \u003cp\u003eThe majority, 354(87.8%) of the respondents were ever pregnant, and the mean age at first pregnancy was 21.06 with standard deviation of \u0026plusmn;\u0026thinsp;2.72 years. Of the forty seven (69.8%) of the respondents were aged\u0026thinsp;=\u0026thinsp;20 years age at first pregnancy. Twenty six (7.3%) of the respondents had experienced a history of induced abortion and, 270(76.3%) of them followed antenatal care at least once among those who gave birth in the last two years. Out Of the respondents, 60 (17%) of them ever had history of birth related complications and, 291(72.2%) of them ever heard of obstetric complications. Two hundred five (57.9%) of them gave birth at health institution with the assistance of skilled birth attendant. Out Of study respondents, 42(11.9%) experienced greater than or equal to six number of pregnancies and 22(6.21%) of them experienced history of prolonged labor. Regarding contraceptive use, 306 (75.9%) of them ever used contraceptives (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReproductive and obstetrics characteristics of the study participants, Chelia district, West Shoa zone, Oromia region, Ethiopia, 2021\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver been pregnant(n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge at first pregnancy(n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eNumber of pregnancy(n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAt least one ANC follow up for recent pregnancy(n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e270\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of giving birth (n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of Prolonged labour(n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e332\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHistory of induced abortion(n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e328\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHistory of birth related complications(n\u0026thinsp;=\u0026thinsp;354)\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHeard obstetric complication(n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eContraceptive use(n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eAwareness of obstetric fistula\u003c/h2\u003e \u003cp\u003eIn this study, 119(29.5%) of the study participants had ever heard of obstetric fistula. The major source of information, 75(63%), was the communication media. Out Of the respondents ever heard about obstetric fistula, those who had ever heard the risk factors, symptoms and prevention methods of obstetric fistula were,111(93.3%),116(97.5%), and 110(92.4%) respectively (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRespondents\u0026rsquo; characteristics of awareness on obstetric fistula in Chelia district, West Shoa zone, Oromia region, Ethiopia, 2021\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eObstetric Fistula\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver Heard obstetric fistula (n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSource of information (multiple response)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily/relatives/friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver heard the risk factors of obstetric? fistula(n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003eRisk factors of obstetric fistula ever heard? (multiple response)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEarly marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProlonged labour\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClosely spaced pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEarly pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnsafe abortion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSexual violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale genital mutilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver heard symptoms of obstetric fistula? (n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eSymptoms of obstetric fistula ever heard\u003c/p\u003e \u003cp\u003e(multiple response)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrinary incontinence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal incontinence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFoul smelling vaginal discharge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRecurrent urinary tract infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver heard prevention methods of obstetric fistula(n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003ePrevention methods of obstetric fistula ever heard (multiple response)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGiving birth at health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDelay early marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContraceptive use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAntenatal care follow up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDelay early pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvoid unsafe abortion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvoid sexual violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAvoid female genital mutilation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eKnowledge of obstetric fistula\u003c/h2\u003e \u003cp\u003eThe overall awareness of obstetric fistula was 20.2% (95% CI: 12.6\u0026ndash;27.7) (Fig.\u0026nbsp;1.)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eFactors associated with awareness on obstetric fistula\u003c/h2\u003e \u003cp\u003eA binary logistic regression model was fitted to assess the statistical association between the different independent variables and obstetric fistula knowledge. Variables with a p-value\u0026thinsp;\u0026le;\u0026thinsp;0.25 on bi-variable logistic regression analysis, were used in multivariable logistic regression analysis to control for potential confounding effects. Accordingly, the place of residence, educational status of respondents, respondents\u0026rsquo; husbands\u0026rsquo; educational status, occupational status, number of pregnancies, health-seeking deciders, place of delivery, birth attendants, contraceptive use, and having prior information about obstetric complications were found to be significantly associated with knowledge of obstetric fistula\u003cb\u003es.\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMultiple logistic regression models were fitted with independent variables that were associated with knowledge of obstetric fistulas using the backward stepwise (likelihood ratio) method, and its fit into the final model was checked using the Hosmer and Lemeshow goodness-of-fit test.\u003c/p\u003e \u003cp\u003eIn multivariable logistic regression analysis, residence, educational status of respondents, giving birth in health institutions, contraceptive use, and having prior information about obstetric complications were associated with knowledge of obstetric fistulas (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eMultivariable logistic regression analysis showed that the odds of having knowledge of obstetric fistula among urban residents were 2.93 times more likely than rural residents (AOR\u0026thinsp;=\u0026thinsp;2.93:95% CI: 1.59\u0026ndash;5.39). The odds of having knowledge were 4.82 times higher among those with more than secondary level of education than among who had no formal education (AOR\u0026thinsp;=\u0026thinsp;4.82:95% CI: 1.56\u0026ndash;14.87). The odds of having knowledge were 2.21 times higher among those who gave birth in health institutions than their counterparts (AOR\u0026thinsp;=\u0026thinsp;2.21:95% CI: 1.27\u0026ndash;3.84). The odds of having knowledge was 2.95 times higher among contraceptive users than non-users of contraceptives (AOR\u0026thinsp;=\u0026thinsp;2.95:95% CI:1.12\u0026ndash;7.06) and, respondents who had prior information about obstetric complication were 3.14 times more likely to have knowledge than respondents who hadn\u0026rsquo;t have prior information about obstetric complications (AOR\u0026thinsp;=\u0026thinsp;3.14:95% CI:1.52\u0026ndash;6.51) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate and multivariate logistic regression analysis of factors associated with knowledge on obstetric fistula among reproductive age women in Chelia District, West Shoa zone, Oromia region, Ethiopia, 2021(n\u0026thinsp;=\u0026thinsp;403)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" morerows=\"1\" nameend=\"c3\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eCategory of variables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eAwareness on obstetric fistula\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR(1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR(1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eYes (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54(54%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46(46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.3[2.66\u0026ndash;6.94]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.93[1.59\u0026ndash;5.39]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65(21.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e238(78.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(38.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30(61.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.05[1.04\u0026ndash;4.03]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.18[0.45\u0026ndash;3.30]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.734\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMore than secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23(63.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13(36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.72[2.65\u0026ndash;12.33]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e4.82[1.56\u0026ndash;14.87]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.006*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39(23.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126(76.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOccupational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(52.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17(47.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.24[1.61\u0026ndash;6.51]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.56[0.96\u0026ndash;6.84]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGovernment employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.76[1.71\u0026ndash;26.72]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.96[0.15\u0026ndash;5.91]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88(25.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e255(74.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eHusband education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61(34.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e116(65.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.31[1.30\u0026ndash;4.12]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.91[0.62\u0026ndash;1.33]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.617*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17(27.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44(72.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.7[0.81\u0026ndash;3.56]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.918[0.32\u0026ndash;2.62]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.873\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMore than secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21(36.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36(63.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.57[1.24\u0026ndash;5.30]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.03[0.35\u0026ndash;3.03]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.963\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e88(81.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026gt;=6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9(21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33(78.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.603(0.26\u0026ndash;1.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.423[0.49\u0026ndash;4.09]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.513\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43(31.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95(68.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHealth seeking decider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eParticipant/woman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28(27.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74(72.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.53[0.21\u0026ndash;1.33]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.37[0.12\u0026ndash;1.15]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eBoth husband and woman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e196(71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.58[0.25\u0026ndash;1.36]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.49[0.18\u0026ndash;1.37]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.172\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHusband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(41.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14(58.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eHealth facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75(36.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e130(63.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.39[1.46\u0026ndash;3.92]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.21[1.27\u0026ndash;3.84\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.005*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eAt home\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29(19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e120(80.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBirth attendant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eSkill birth attendant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75(37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e130(63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.12[1.17\u0026ndash;3.83]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.24[0.48\u0026ndash;3.18]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.659\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eRelatives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66(78.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eContraceptive use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e103(34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e203(66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.57[1.43\u0026ndash;4.62]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.95[1.23\u0026ndash;7.06]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.015*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16(16.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e81(83.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eHeard obstetric complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108(37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e183(63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.42[2.78\u0026ndash;10.55]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e3.14[1.52\u0026ndash;6.51\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.002*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11(9.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e101(90.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003e\u003cb\u003eKey: * Statistically significant at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussions","content":"\u003cp\u003eThis community-based study was carried out to assess\u0026nbsp;the\u0026nbsp;knowledge\u0026nbsp;of obstetric fistulas and associated factors among women of reproductive age\u0026nbsp;living in Chelia district, West Shoa zone, Oromia region, Ethiopia. The study showed that the factors found to have\u0026nbsp;a statistically significant association with\u0026nbsp;knowledge\u0026nbsp;of obstetric fistula among\u0026nbsp;women of reproductive age\u0026nbsp;were place of residence, educational status of participants, and place of delivery, contraceptive use, and\u0026nbsp;prior information about obstetric complications.\u003c/p\u003e\n\u003cp\u003eThe study revealed that 20.2% (95% CI=12.6-27.7) of the respondents had good\u0026nbsp;knowledge\u0026nbsp;of obstetric fistulas in the study area. This finding is consistent with a study conducted among reproductive age women in Ethiopia (23.2%)\u0026nbsp;(19).\u003c/p\u003e\n\u003cp\u003eThe findings of this study\u0026nbsp;are lower than studies conducted in Nigeria (57.8%)(3), Northern Ghana(45.8%)(34),\u0026nbsp;and Bench Sheko Zone, Ethiopia(40.8%)\u0026nbsp;(21). A possible explanation for this discrepancy may be the study setting, study participants, and sociodemographic factors. In Nigeria, the study was conducted on pregnant women who presented for routine antenatal clinic visits; therefore, the difference might be due to the study setting and participants. \u0026nbsp;The study in Ghana was conducted in the age group of 17-60 years, the socio-demographic characteristics of the respondents in the study might be the reason for the difference.\u003c/p\u003e\n\u003cp\u003eThe study revealed that the odds of having knowledge of obstetric fistulas\u0026nbsp;were significantly associated with place of residence, in which urban residents were 2.93 times more likely to have good\u0026nbsp;knowledge\u0026nbsp;than their rural counterparts. This finding is consistent with\u0026nbsp;that reported by Burkina Faso, who found that rural residents were less likely to have better knowledge than urban residents(26). This might be explained by the fact that women residing in urban\u0026nbsp;areas might have more\u0026nbsp;access to information, easier accessibility to health facilities, and\u0026nbsp;exposure to different sources of information in contrast to their rural counterparts.\u0026nbsp;\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study showed that\u0026nbsp;women of reproductive age\u0026nbsp;who attained more than\u0026nbsp;a secondary level of education were 4.82 times more likely to have good\u0026nbsp;knowledge\u0026nbsp;of obstetric fistula than women who had no formal education. This finding is consistent with that\u0026nbsp;of a study conducted in Southwest of Ethiopia in Ilu Aba\u0026nbsp;Bor zone\u0026nbsp;(24).\u003c/p\u003e\n\u003cp\u003eThis consistency might be by the fact that, those attending formal education have greater opportunities to get information from different reading materials than those who had no formal education.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study findings revealed that\u0026nbsp;the place of giving birth was significantly associated with knowledge of obstetric fistula, as the odds of having\u0026nbsp;knowledge were 2.21 times higher among those who gave birth at health institutions than among those\u0026nbsp;who gave birth at home. Similarly,\u0026nbsp;a study conducted in\u0026nbsp;the\u0026nbsp;southeastern zone of Tigray concluded\u0026nbsp;that women who gave birth at health institutions were more likely to have good\u0026nbsp;knowledge\u0026nbsp;of obstetric fistulas\u0026nbsp;than those who had experience of home delivery(28). \u0026nbsp;Another study conducted in Ethiopia on\u0026nbsp;the determinants of obstetric fistulas is\u0026nbsp;consistent with this study(29). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe consistency of this finding might be explained by the fact that with the issue of postpartum care, obstetric complications, including obstetric fistula, can be informed together as postpartum care activities.\u003c/p\u003e\n\u003cp\u003eThe study showed that contraceptive users were 2.95 times more likely to have knowledge of obstetric fistulas than their counterparts. Conversely, findings from the Nigerian Demographic Health cross-sectional survey to determine\u0026nbsp;knowledge\u0026nbsp;among reproductive-age women identified that women with a history of contraceptive use had lower odds of being aware of\u0026nbsp;a fistula\u0026nbsp;than those with no history of contraceptive use(16).\u003c/p\u003e\n\u003cp\u003eA possible explanation for this difference might be\u0026nbsp;that the study in Nigeria utilized secondary data from the Demographic Health Survey, whereas\u0026nbsp;in this study, community-based data were utilized, and socio-demographic characteristic discrepancies might\u0026nbsp;have contributed to the difference.\u003c/p\u003e\n\u003cp\u003eThe current study showed that\u0026nbsp;having prior information about obstetric complications was significantly associated with knowledge of obstetric fistulas, in which the odds of having awareness of obstetric fistula was 3.14 times higher among study participants who had prior information than their counterparts\u003cstrong\u003e.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;This finding is in line with that of a study conducted in the southeastern zone of Tigray, in which women with prior information on obstetric complications were more aware than their counterparts(28). This similarity might be explained by the fact that the issue of obstetric fistula can also be informed together with the dangers of pregnancy, since it is one of the childbirth complications.\u003c/p\u003e"},{"header":"Conclusion and Recommendations","content":"\u003cp\u003eThe findings of this study showed that the knowledge of obstetric fistulas was low. Place of residence, educational status, institutional delivery, contraceptive use, and prior information about obstetric complications were found to be significantly associated with knowledge of obstetric fistulas. Therefore, healthcare providers, district health offices, zonal health offices, and policymakers are recommended to work hard on awareness creation, early identification, and management of obstetric fistulas. Additionally, consistent contraceptive use and skilled birth attendant uptake are recommended at all levels. Moreover, interested researchers are also recommended to conduct further studies with different designs, including qualitative aspects of the study, to obtain additional detailed findings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from Ambo University Institutional review board with reference number of PGC/237/2021.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVerbal informed consent was obtained from legally authorized representatives before the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was conducted in the absence of any human related samples since it was not an experimental study. Thus trial registration is not applicable for this particular study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcronyms and Abbreviations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eANC, antenatal care; EDHS, Ethiopian Demographic Health Survey; FGM, Female Genital Mutilation; IEC, Information, Education, and Communication; RVF: Recto Vaginal Fistula; SPSS: Statistical Package for Social Science; SSA: Sub-Saharan Africa; VVF: Vesicovaginal fistula; WHO: World Health Organization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors conceived study protocol, participated in study design, analysis, report writing, and drafted the manuscript. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eWe are grateful to Ambo University, College of Medicine and Health Sciences, and the\u0026nbsp;Chelia District Health Office for their contribution to this study.(\u003ca href=\"#_ENREF_2\" title=\"Buli TD, 2023 #99\"\u003e2\u003c/a\u003e)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eTun\u0026ccedil;alp \u0026Ouml;, Tripathi V, Landry E, Stanton K, Ahmed S. Measuring the incidence and prevalence of obstetric fistula : approaches , needs and recommendations. 2015;(December 2014):60\u0026ndash;2.\u003c/li\u003e\n \u003cli\u003eTebeu PM, Fomulu JN, Khaddaj S, De Bernis L, Delvaux T, Rochat CH. Risk factors for obstetric fistula: A clinical review. Int Urogynecol J. 2012;23(4):387\u0026ndash;94.\u003c/li\u003e\n \u003cli\u003eEzeonu PO, Ekwedigwe KC, Isikhuemen ME, Eliboh MO, Onoh RC, Lawani LO. Awareness of Obstetric Vesicovaginal Fistula among Pregnant Women in a Rural Hospital. 2017;39\u0026ndash;46.\u003c/li\u003e\n \u003cli\u003eKasamba N, Kaye DK, Mbalinda SN. Community awareness about risk factors, presentation and prevention and obstetric fistula in Nabitovu village, Iganga district, Uganda. BMC Pregnancy Childbirth. 2013;13.\u003c/li\u003e\n \u003cli\u003eLancet. Double burden of tragedy: stillbirth and obstetric fi stula Pattern. 2016;4(February):80\u0026ndash;2.\u003c/li\u003e\n \u003cli\u003eHilton P, Hilton P. Trends in the aetiology of urogenital fistula : a case of \u0026lsquo; retrogressive evolution \u0026rsquo; ? Int Urogynecol J. 2016;831\u0026ndash;7.\u003c/li\u003e\n \u003cli\u003eMuseum MF. Strategy to End Obstetric Fistula in West and Central Africa 2019\u0026ndash;2030. 2019;45(45):95\u0026ndash;8.\u003c/li\u003e\n \u003cli\u003eDememew ZG. Obstetric fistula situation in Ethiopia Zewdu Gashu Dememew Johns Hopkins University-Technical Support for the Ethiopian HIV/AIDS Initiative, Hawassa Ethiopia. 2019;\u003c/li\u003e\n \u003cli\u003eNy N. Background Guide 2016 National Model United Nations. 2016;\u003c/li\u003e\n \u003cli\u003eAdler AJ, Ronsmans C, Calvert C, Filippi V. Estimating the prevalence of obstetric fistula : a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013;13(1):1\u0026ndash;14.\u003c/li\u003e\n \u003cli\u003eBiswas N, Mahmood I DS. Genital Fistula: Successes,Challenges,and Way Forward in a facility Specialization in Fistula Management in Bangladesh. 2019.\u003c/li\u003e\n \u003cli\u003eDuby F, Box GPO. Joint AusAID and USAID Review of Support to Hamlin Fistula Ethiopia ( Ethiopia ) Final report. 2013;61(2).\u003c/li\u003e\n \u003cli\u003eKaewkiattikun K. Effects of immediate postpartum contraceptive counseling on long-acting reversible contraceptive use in adolescents. Vol. Volume 8, Adolescent Health, Medicine and Therapeutics. 2017. 115\u0026ndash;123 p.\u003c/li\u003e\n \u003cli\u003eBanke-Thomas AO, Wilton-Waddell OE, Kouraogo SF, Mueller E. Current evidence supporting obstetric fistula prevention strategies in sub Saharan Africa: a systematic review of the literature. Afr J Reprod Health. 2014;18(3):118\u0026ndash;27.\u003c/li\u003e\n \u003cli\u003eMuleta, M, Fantahun M, Tafesse B, Hamlin EC, Kennedy RC. Obstetric Fistula in Rural Ethiopia. 2007;84(11):526\u0026ndash;34.\u003c/li\u003e\n \u003cli\u003eMorhason- IO, Kareem YO, Bello OO, Lawal OO, Akinlusi FM, Abegunde LO, et al. Factors associated with the awareness of vaginal fistula among women of reproductive age : findings from the 2018 Nigerian demographic health cross- \u0026shy; sectional survey. 2020;(iii):1\u0026ndash;13.\u003c/li\u003e\n \u003cli\u003eChelia district Health Office. Chelia district Health Office Background Information 2021. 2021;\u003c/li\u003e\n \u003cli\u003eWall LL. Obstetric Fistula Is a \u0026lsquo;\u0026ldquo; Neglected Tropical Disease .\u0026rdquo;\u0026rsquo; 2012;6(8):8\u0026ndash;10.\u003c/li\u003e\n \u003cli\u003eBiadgilign S, Lakew Y, Reda AA, Deribe K. A population based survey in Ethiopia using questionnaire as proxy to estimate obstetric fistula prevalence: Results from demographic and health survey. Reprod Health. 2013;10(1):1\u0026ndash;8.\u003c/li\u003e\n \u003cli\u003eInstitutions TH, Zone A, West N, Beyene FY. Awareness and its Associated Factors of Obstetrics Fistula among antenatal care attendees in Injibara. 2019;1\u0026ndash;15.\u003c/li\u003e\n \u003cli\u003eAsefa Z, Amenu D, Berhe A. Awareness of Obstetric Fistula and its Associated Factors among Reproductive-age Group Women in Bench Sheko Zone , Southwest , Ethiopia . Community based Cross-Sectional Study.:1\u0026ndash;6.\u003c/li\u003e\n \u003cli\u003eJarvis K, Richter S, Vallianatos H, Thornton L. Reintegration of Women Post Obstetric Fistula Repair: Experience of Family Caregivers. Glob Qual Nurs Res. 2017;4.\u003c/li\u003e\n \u003cli\u003eOmari J, Wakasiaka S, Khisa W, Omoni G, Lavender T. Women and men\u0026rsquo;s awareness of obstetric fistula in facilities in Kisii and Nyamira Counties, Kenya. African Journal of Midwifery and Women\u0026rsquo;s Health. 2015 Jan 2; 9(1):12-6.\u003c/li\u003e\n \u003cli\u003eRundasa DN, Wolde TF, Ayana KB, Worke AF. Awareness of obstetric fistula and associated factors among women in reproductive age group attending public hospitals in southwest Ethiopia, 2021. Reprod Health. 2021;18(1).\u003c/li\u003e\n \u003cli\u003eYusufi MO, Fanning E, Bhatta MP. Determinants of obstetric fistula in Afghanistan: An analysis of the Demographic and Health Survey 2015. Int J Gynecol Obstet. 2022;2015.\u003c/li\u003e\n \u003cli\u003eBanke-thomas AO, Kouraogo SF, Siribie A, Taddese HB, Mueller E. Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso : A Cross-Sectional Study. 2013;8(12):1\u0026ndash;8.\u003c/li\u003e\n \u003cli\u003eTollosa DN, Kibret MA, Ababa A. International Journal of Medical Research. 2013;2(2):261\u0026ndash;7.\u003c/li\u003e\n \u003cli\u003eAsfaha BT. Awareness on presentation of obstetric fistula and associated factors among reproductive age women in south eastern zone of tigray , ethiopia , 2020 . cross sectional study. 2021;1\u0026ndash;20.\u003c/li\u003e\n \u003cli\u003eAsrat Atsedeweyn Andargie AD. Determinants of obstetric fistula in Ethiopia. Afri Heal Sci 2017;17(3). 2017;17(3):671\u0026ndash;80.\u003c/li\u003e\n \u003cli\u003eRs K, Ej M. Perceived causes of obstetric fistulae from rural southern Tanzania. 2011;11(3).\u003c/li\u003e\n \u003cli\u003eWall LL. A Framework for Analyzing the Determinants of Obstetric Fistula Formation. 2012;43(4):255\u0026ndash;72.\u003c/li\u003e\n \u003cli\u003eAhmed S, Tun\u0026ccedil;alp \u0026Ouml;. Burden of obstetric fistula: From measurement to action. Lancet Glob Heal [Internet]. 2015;3(5):e243\u0026ndash;4. Available from: http://dx.doi.org/10.1016/S2214-109X(15)70105-1\u003c/li\u003e\n \u003cli\u003eSemira Defar. Awareness on obstetric fistula and its associated factors among reproductive age women in Asella town Oromia region, Ethiopia. 2018;(June).\u003c/li\u003e\n \u003cli\u003eF SM. A survey on obstetric fistula awareness in Northern Ghana. Eur J Exp Biol. 2014;4(4):178\u0026ndash;82.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Obstetric fistula, knowledge, reproductive age women, Chelia, Oromia","lastPublishedDoi":"10.21203/rs.3.rs-5052009/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5052009/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Obstetric fistula is a hole between vagina and rectum or bladder that leads to continuous leakage of urine and/or feces.Globally, approximately 50,000-100,000 women develop fistulas annually, and approximately 2 million currently live with fistulas, which is a burden in almost 60 countries and continues to be a neglected public health problem. Ethiopia is a developing country with poor maternal healthcare and high prevalence of obstetric fistulas.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e This study aimed to assess knowledge of obstetric fistula and associated factors among women of reproductive age in Chelia district, WesternEthiopia, in 2021.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Community-based cross-sectional study was conducted among 403 participants who were randomly selected and enrolled between September 25 and October 30, 2021. Pretested and structured questionnaires were used to collect data. Bivariable and multivariable logistic regression analyses were performed to identify associated factors. Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to determine the degree of association, and statistical significance was declared at a p-value of \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThis study showed that 20.2% (95% confidence interval: 12.6-27.7) of reproductive age women had a good knowledge of obstetric fistula\u003cstrong\u003e.\u003c/strong\u003eIndependent variables such as living in urban (AOR=2.93:95% confidence interval:1.59-5.39), educational attainment of more than secondary (AOR =4.82:95% confidence interval:1.56-14.87), institutional delivery (AOR=2.21:95% confidence interval: 1.27-3.84), contraceptive use(AOR=2.95:95% confidence interval:1.23-7.06) and having prior information on obstetric complications (AOR =3.14:95% confidence interval:1.52-6.51) were found to be significantly associated with knowledge of obstetric fistula.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions and Recommendations:\u003c/strong\u003e This study showed that awareness of obstetric fistulas is low. Residence, educational status, institutional delivery, contraceptive use, and prior information on obstetric complications were significantly associated with awareness of obstetric fistulas. Therefore, special attention should be paid to the identified factors of maternal healthcare issues, particularly obstetric fistulas.\u003c/p\u003e","manuscriptTitle":"Knowledge of obstetric fistula and associated Factors among reproductive age women in Chelia District, West Shoa Zone, Oromia Region, Ethiopia A community based cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-24 07:47:19","doi":"10.21203/rs.3.rs-5052009/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"73199bd1-d2c5-419c-9041-f81882723c73","owner":[],"postedDate":"October 24th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-21T22:08:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-24 07:47:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5052009","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5052009","identity":"rs-5052009","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}