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Objective: To assess health, social, and psychological problems encountered by women with treated and untreated obstetric fistula (OF)., Methods: A cross-sectional study consisting of quantitative and qualitative components was conducted in seven administrative regions of rural Ethiopia. Fifty-two women with OF were interviewed on the subjects of their socioeconomic status and history of the development of OF. Qualitative in-depth interviews were conducted with 27 of the untreated women and seven of the treated women., Results: A total of 19 153 houses were surveyed, and 55 women with fistulae were identified, of whom 52 were interviewed. Thirty-six of the interviewed women (69.2%) were divorced, 10 (19.2%) were not allowed to eat with family members, and 23 (44.2%) were not members of any community associations. Of the 48 women with feelings of depression, 28 (54.2%) had suicidal ideation. Twenty-four women attributed their development of a fistula to evil spirits, to a curse, or to sin. The in-depth interviews revealed that treatment improved family and social life; however, some health, social, and sexual problems remained., Conclusion: Women with OF encounter health, psychological, and social consequences that are not completely resolved by repairing the fistula. The care of women with OF should go beyond surgical treatment and should include support for their reintegration into the community with proper follow-up.

Objectives: To determine the prevalence of obstetric fistula in rural Ethiopia and identify the circumstances and barriers to care that enhance development of obstetric fistula and its health and social consequences., Design: A cross-sectional study., Setting: The study was conducted in seven out of eleven administrative regions of Ethiopia by visiting randomly selected houses in rural areas and identifying women who have or had obstetric fistula and interviewing them., Results: A total of 19,153 houses were visited. Untreated fistula prevalence was about 1.5 per 1000 amounting to approximately 26,819 women. Most of the patients were young women who delivered for the first time. Marriage took place early in life mostly through family arrangements or abduction. The median number of days in labour was three to eight., Conclusion: Promotive measures such as increasing age at marriage, and identification and treatment of patients should be intensified. There is a great need in improving accessibility and affordability of basic and emergency obstetric services for rural communities. Curving the situation in the long run requires dealing with the problem of poverty and improvement in the status of women.