Hypothesis / aims of study
Introduction
Male involvement in maternal health issues such as obstetric fistula care is currently drawing the attention of organizational bodies and governmental agencies and stakeholder globally. The increasing advocacy to eradicate obstetric fistula worldwide have identified the need to consider the involvements of male partner in interventional efforts, especially in the goal of prevention, treatments and reintegrating of the woman back into community after repair .
Obstetric Fistula is deeply an unpleasant condition, resulting in constant leakage of urine and faeces through the vagina. For more than three decades the condition has been labelled as one of the silent epidemics in Africa which is still making headline as a remarkable maternal health issue. According to the World Health Organization [WHO] (2019), in Africa alone an estimated 2-3 million women and girls are living with Obstetric Fistulas. Also between 50 000 to 100 000 women diagnosed yearly with the highest prevalence of 300, 000 solely in the sub-Saharan African countries with approximately 700 new cases reported annually in Ghana. Male partners in their quest to support their spouses and partners have varied experiences and stories to share. However, there is a lack of ample evidence on male partners and spousal involvements in the are and treatment of women and girls with the devastating but preventable Obstetric fistula condition. The identified gap in the literature has to do with the stories on male partners involvement in the treatment and care of women suffering form Obstetric Fistula.
Study Aim:
The study sought to help understand the in-depth experiences and stories of Male partners who are living with women with Obstetric fistula.
Study design, materials and methods
Using the qualitative approach, the narrative inquiry design was used as a framework to understand the participants’ experiences and their reflections in living with women with Obstetric Fistula in Africa. This qualitative study was conducted with purposeful and criteria-based sampling selection from August to October, 2019. Face to face conversational interviews with unstructured interview guide was used to enhance the conversation from three male participants between the ages of 32-60 who voluntarily consented and agreed to go through the research. Agreed pseudonyms of participant numbers were used for anonymity and confidentiality sake to comply with ethics rules.. Verbatim transcriptions of the narrations were turned into text and narrative content analysis (Rantakari & Vaara, 2017:271) was used to analyse the collected data.
Interpretation of results
Theme 1: “Psychosocial ad emotional torture and reality”,
“[...] Hmmm, I must say that with all the years of experience in living a woman with leakage of urine , its never been easy at all, its been a real hustle because it looks like mystery yet a reality on the grounds.The experience is more than a mental torture and its full of household responsibilities , taking care of the sick wife, the children and struggle to get some monies for the house, ensuring all matters surrounding the experience is kept in private. I tell you its never an easy task at all, sometime I have to lie about what is happening when I am questioned as to why I am always doing the house chores "
Participant 2, 42 years old
Participant 3 lamented that:
" The reality is that I am talking about a woman who was very beautiful and whenever she undress in my presence I felt satisfied with her but honestly as it stands now, I am dying within because I feel bothered about every about her but I wouldn't like her to also know what I am going through.i thought I will be enjoying my marriage with my pension baby and my beautiful wife but its rather unfortunate it did not turn out the way I anticipated and planned it. Tell me ! what you will go on with your mind if you were in such a situation. wouldn't it have been stressful for you ? I am actually stressed I must say but we are in the hardship together. I need to continually support her after all what will gain leaving her for another woman at my age. There is no need although my I am still sexually active. I could only pray for some positive change and miracle to happen when see goes for the operation (surgery) as discussed."
Participant 3, 60 years
Theme 2 : “Deprivation and changes with sexual life”,
”In fact living in the same roof with a woman you are married to and had sexual intercourse with for years and reflecting that before the disease condition, her looks sometimes initiate sexual activities. Now I am unable to have sex intercourse with her because of the condition and she doesn't also look attractive any longer in current state. I no longer have access to her as it used to be. For me I can only give myself a year..."
Participant 1, 39 years old
" [CRYING] I am absolutely tired of this punishment in marriage.
... madam its getting too difficult now because ever since my wife delivered and had the fistula condition I have been without sex intercourse for 2 solid years and its getting difficult. If I tried going close, she complains of lower abdominal pain and cries. I smell alone few minutes after bathing puts me off from sex. Sometime she ask me whether I feel for other women or feel for sex but I could only answer her with another question: how do you see the situation? and just leave it there."
Participant 2, 42 years old
Theme 3 : “divorce is an option if resilience to support fails”.
[...] I think I have done my best supporting my wife in this journey but I am a man who need a woman who will satisfy me. I know she could testify that I have supported her so much, going extra mile of doing the thing any man will do for a wife but if the condition persist I have no option than to leave the marriage for another woman because I have no child " Participant 1, 39 years