Objective: To examine the reproductive, sociodemographic, and geographic factors associated with obstetric fistula, which is a significant but neglected health problem faced by women in low-income countries, in women in Afghanistan, where epidemiologic studies examining the determinants of obstetric fistula are currently lacking.
Methods: This cross-sectional study used data from a nationally representative sample of women collected through the Afghanistan Demographic and Health Survey 2015. Descriptive and binary and multivariable logistic regression analyses were performed to estimate the prevalence of obstetric fistula and describe and assess the risk factors associated with the condition.
Results: Among the weighted sample of 29 374 women aged 15-49 years, 3% reported having an obstetric fistula. In a multivariable logistic regression analysis, factors associated with women reporting a history of an obstetric fistula included parity, ethnicity, geography, income level, educational attainment, employment outside the home, decider on medical care, and their husband's education level.
Conclusion: Our findings highlight the multifactorial nature of the determinants of obstetric fistula in Afghan women and underscore the need for multidisciplinary integrative interventions to address the reproductive, socio-economic, cultural, and healthcare-related factors in reducing the burden of obstetric fistula in women in Afghanistan.
Keywords: Afghanistan; demographic and health survey; obstetric fistula; risk factors.
© 2022 International Federation of Gynecology and Obstetrics.