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A Grounded Theory of Regaining Normalcy And Reintegration of Women with Obstetric Fistula in Kenya

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dc.contributor.author Khisa, Anne M.
dc.contributor.author Nyamongo, Isaac K.
dc.contributor.author Omoni, Grace M.
dc.contributor.author Spitzer, Rachel F.
dc.date.accessioned 2022-02-23T07:52:54Z
dc.date.available 2022-02-23T07:52:54Z
dc.date.issued 2019
dc.identifier.citation Khisa AM, Nyamongo IK, Omoni GM, Spitzer RF. A grounded theory of regaining normalcy and reintegration of women with obstetric fistula in Kenya. Reprod Health. 2019 Mar 8;16(1):29. doi: 10.1186/s12978-019-0692-y. PMID: 30849992; PMCID: PMC6408802. en_US
dc.identifier.issn 1742-4755
dc.identifier.other DOI: 10.1186/s12978-019-0692-y
dc.identifier.uri https://pubmed.ncbi.nlm.nih.gov/30849992/
dc.identifier.uri http://localhost:8080/xmlui/handle/123456789/538
dc.description A research article en_US
dc.description.abstract Background: Obstetric fistula is a reproductive health problem causing immense suffering to 1% of women in Kenya that is formed as sequelae of prolonged obstructed labour. It is a chronic illness that disrupts women lives, causing stigma and isolation. Fistula illness often introduces a crisis in women’s life begetting feelings of shame and serious disruption to their social, psychological, physical and economic lives, in addition to dealing with moral and hygiene challenges. Currently, women undergo free of charge surgery at vesicovaginal fistula (VVF) camps held in national referral hospitals and dedicated fistula centres generating a significant pool of women who have undergone surgery and are ready to regain normal lives. Objective: The purpose of this study was to explore experiences of women immersing back into communities and their return to normalcy after surgery in three VVF repair centres in Kenya. We set out to answer the question: what strategies improve obstetric fistula patients’ reintegration process? Methods: We used grounded theory methodology to capture the reintegration and regaining normalcy experiences of women after surgery. Narrative interviews were held with 60 women during community follow-up visits in their homes after 6–19 months postoperatively. Grounded theory processes of theoretical sampling, repeated measurement; constant comparative coding in three stage open, axial and selective coding; memoing, reflexivity and positionality were applied. Emergent themes helped generate a grounded theory of reintegration and regaining normalcy for fistula patients. Results: To regain normal healthy lives, women respond to fistula illness by seeking surgery.. After surgery, four possible outcomes of the reintegration process present; reintegration fully or partially back into their previous communities, not reintegrated or newly integrating away from previous social and family settings. The reintegration statuses point to the diversity outcomes of care for fistula patients and the necessity of tailoring treatment programs to cater for individual patient needs. Conclusion: The emerging substantive theory on the process of reintegration and regaining normalcy for fistula patients is presented. The study findings have implications for fistula care, training and policy regarding women’s health, suggesting a model of care that encompasses physical, social, economic and psychological aspects of care after surgery and discharge. en_US
dc.description.sponsorship This PhD research was partly funded by a fellowship award by the Consortium for Advanced Research Training in Africa (CARTA). CARTA has been funded by WelcomeTrust UK Grant No. 087547/Z/08/Z; Department for International Development (DfID) under the Development Partnerships in Higher Education (DelPHE); Carnegie Corporation of New York (Grant No. B8606); Ford Foundation (Grant no110–0399); Google.org (Grant no 191994) Sida (Grant No 54100029) and the Bill and Melinda Gates Foundation (grant no. 51228). 2. This PhD research was partly funded by African Doctoral Dissertation Fellowship (ADDRF) award offered by the African Population and Health Research Centre in partnership with the International Development Research Centre (IDRC) en_US
dc.language.iso en en_US
dc.publisher Biomed Central en_US
dc.subject Reintegration en_US
dc.subject Regaining normalcy en_US
dc.subject Kenya en_US
dc.subject Obstetric fistula en_US
dc.subject Narratives en_US
dc.subject Grounded theory en_US
dc.title A Grounded Theory of Regaining Normalcy And Reintegration of Women with Obstetric Fistula in Kenya en_US
dc.type Article en_US

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