Obstetric Fistula in Malawi: Prevalence and Correlates

Kiersten Johnson, ORC Macro

Fistula is a severe medical condition usually arising from the experience of obstructed childbirth. It consigns the affected woman to a lifetime of physical, social and economic disability if the injury is not repaired. It is most common among those who have the least – the poor, the undernourished, and the underserved. Despite the critical importance of the problem of fistula, no national prevalence data have been collected in any country in the developing world, until recently. This paper documents the first effort to collect national prevalence data on fistula, determines whether the data reasonably reflect the prevalence of fistula in Malawi, and discerns risk factors associated with the experience of fistula, using bivariate and multivariate methods. Data from the 2004-05 Malawi Demographic and Health Survey (MDHS) were used for this analysis. 12,229 women were eligible for interview, and 11,698 were successfully interviewed, yielding a response rate of 95.7 percent.