The Influence of Mass Media Campaigns on Obstetric Fistula in Nigeria

Diploma Thesis, 2022

45 Pages, Grade: 3.50/4.00




1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objectives of the Study
1.4 Research Questions
1.4Scope of the Study
1.5 Significance of the Study
1.6 Limitation of the Study
1.7 Definition of Terms

2.1. Review of Relevant Literature
2.2 Theoretical Framework

3.1. Research Design
3.2. Population of the Study
3.3. Sample Size
3.4. Sampling Procedure
3.5. Validity of the Instrument
3.6. Reliability of the Instrument
3.7. Method of Data Collection
3.8. Method of Data Analysis and Discussion

4.1. Preamble
4.2. Analysis of Respondents' Bio-Data
4.3. Presentation and Analysis of Psychographic Data Collected
4.4. Discussion of Findings

5.1. Summary
5.2. Conclusion
5.3. Recommendations




A persistent, involuntary release of urine or faeces into the vagina is a symptom of obstetric fistula, an improper connection between the urinary bladder and the vagina. This study analyses the effect that public awareness programmes have had on the prevalence of obstetric fistula in Nigeria. The researcher used a survey approach to collect data for this study, and a well-crafted questionnaire was used to elicit participant feedback. The results demonstrate that residents of Niger State have a deep understanding of obstetric fistula. The survey also indicated that radio and word of mouth are the most common ways that individuals learn about news and events. In addition, it was found that the language barrier, the frequency of awareness campaigns, and uninteresting awareness programmes were all obstacles to using the media in campaigns against obstetric fistula. Campaigns have a relatively high impact in reducing the prevalence of obstetric fistula. The study concludes that the awareness campaign should tell individuals about the effects of early marriage, which local languages should be used throughout the campaigns, and that trained counsellors should be employed during the seminars.



1.1 Background of the Study

Media campaigns have been used by governments, people, groups, and other public entities for a long time in an effort to better the public’s health. This work has been applied to every facet of the human experience. The goal of these initiatives is to raise public consciousness to a level where individuals will be better able to steer their own lives. These efforts have often been focused on aiding one or the other sex. Breast cancer awareness, cervical cancer awareness, pelvic inflammatory disease awareness, vaginal fistula awareness, and obstetric fistula awareness are just a few examples of campaigns that show how important these issues are to women. For this reason, the impact of a media campaign on the incidence of obstetric fistula in Nigeria is assessed here.

Inadequate medical equipment, poverty, illiteracy, and primitive ways to life in terms of religion and culture all contribute to the prevalence of obstetric fistula among women in Nigeria’s rural and remote areas today. Despite the obviousness of the aforementioned reason, the weight of this delivery injury should fall heavily on the media, which is charged with informing, educating, and establishing agenda for rural residents. Mass media have a responsibility to inform and raise awareness of Obstetric Fistula, especially among people living in rural areas and the government, due to the causes described above. It is disseminated in the form of campaigns to inform or confront the government about the state of hospitals and the absence of life-saving technology, and to teach and educate women that getting an early C-section after a protracted birth might rescue them from a lifetime of pain.

Mediated methods of communication such as radio, television, newspapers, magazines, word of mouth, etc. are typically used for the Obstetric Fistula campaigns. Since it can reach such a large number of people so quickly, this is the main reason. “The mainstream media have acquired appeal because of their capacity to reach a great majority of people within a short period,” argues Hurdle (2001), as cited by Agughasi (2012).

Without a shadow of a doubt, obstetric fistula is now seen as a serious health concern in Nigeria, necessitating powerful public efforts to limit its recurrence. The National Foundation on Fistulae (2003) claims that “efforts to remedy the problem have so far remained restricted in breadth, coverage, and uncoordinated,” with most initiatives being led by NGOs, some state governments, and, more recently, the Federal government. For instance, the Nigerian government’s Federal Ministry of Health (FMH) and the United Nations Population Fund Agency (UNFPA) agreed that obstetric fistula treatment must be part of a broader strategy to enhance women’s sexual and reproductive health and reduce maternal mortality and morbidity. This practice led to the creation of the National Strategic Frame Work for Eradication of Fistula in Nigeria (Lawrence, 2010).

Many public, non-profit, and individual initiatives (such as the UN-backed Campaign to End Fistula) are now underway to raise awareness of the problem and find solutions. Radio is a particularly effective medium for spreading the word about the fight against Obstetric Fistula in Nigeria, where the disease is particularly widespread in the country’s northern regions. The occurrence of obstetric fistula in Nigeria remains alarmingly high despite ongoing awareness programmes. For instance, in practically all of the states in Northern Nigeria, Medicine San Frontier (Doctors without borders) is fighting actively against Obstetric Fistula and Vesico Vaginal Fistula through multiple awareness campaigns, free treatment of patients, and rehabilitation/reintegration programmes. Despite these advances, many individuals remain clueless about the root causes, preventative methods, and management of Obstetric Fistula.

A traumatic birthing injury, obstetric fistula occurs when an irregular hole forms between the bladder or rectum and the vagina, resulting in urine or faeces incontinence (Bangser, 2006). What this means is that there is an abnormality in the connection between the rectum (which controls urination) and the vagina. A hole can occur between the birth canal and the bladder or rectum, which can cause constant/involuntary flow of urine, faeces, and blood. It is only seen in females and can be brought on by complications during labour and delivery. Deterioration of the tissues connecting the vagina to the bladder or rectum is the result of this birth canal illness. This degradation makes it difficult for women to regulate their bowel and bladder movements, causing them tremendous agony, suffering, and embarrassment. While some women are able to lean on their loved ones for assistance, the majority of the poor population consists of women who live alone (USAID, 2003).

With the development of obstetric care, this problem has been eliminated in affluent nations, but it continues to be one of the ignored causes of chronic maternal morbidity, especially in poor and middle income nations (Cook et al., 2004). Obstructed labour is a primary cause of obstetric fistula, however it is not the only direct reason. Besides these, fistula can be caused by instrumental treatments like surgery, as well as by congenital conditions, radiation, and cancer. These latter reasons are more common in industrialised nations (Cook et al., 2004 and Abrams, 2012).

Prolonged labour owing to cephalopelvic disproportion, and the pelvis of the teenage not being completely grown as during pregnancy, making the pelvic often too small for the baby, are also included as key reasons of Obstetric fistula in Nigeria in the report of the National Foundation on Fistulae (2003). Ischemic necrosis of the interstitial soft tissues is caused by prolonged labour in which the baby’s head leans too heavily against the back of the pelvic bone (Andrew, 2011). One of the primary reasons for obstetric fistula is a hasty wedding. Patients with obstetric fistula were more likely to have married at a young age in Northern Nigeria, with 81.5% of Kaduna patients and 52% of Maiduguri fistula patients having married by the age of 15. (Benjamin, 2010). The fact that early marriage is not the sole cultural ractice that causes obstetric fistula should not be overlooked. Female genital mutilation is FGM’s twin sister, and it is widespread in Northern Nigeria. Traditional therapy for diseases including dyspareunia, infertility, congenital vaginal septum, vaginal infections, amenorrhea, and vaginal discharge by the insertion of herbs and drugs into the virginal. The vaginal wall is damaged not by the plant itself but by the method of preparation (Lawson, 1998).

Obstetric fistula is a widespread issue across Africa, not just in Nigeria. “Obstetric fistula constitutes one of the major gynaecological problems in developing countries because of the high incidence of obstetric complications,” wrote Lawson (1998), as cited by the National Foundation on Fistulae (2003). However, this problem is not uniformly distributed throughout the developing world. Communities where malnutrition and untreated infections stunt the growth of future mothers during childhood and adolescence are more likely to have an increased incidence of contracted pelvis. According to additional research, survivors of obstructed labour often sustain bladder or rectal injuries due to the lack of nearby maternity care facilities, making cephalopelvic disproportion the leading cause of obstetric fistula (2003).

It is important to remember that several Nigerian research have reported different causes of obstetric fistula. While obstetric fistula is entirely avoidable, research from around the country suggest that it is nevertheless rather frequent (Ijaiya, 2010). If individuals were better informed about the dangers of obstetric fistula, the problem would not exist in modern society. Thus, the purpose of this research is to evaluate the effect of public awareness initiatives on the prevalence of obstetric fistula in Nigeria.

1.2 Statement of the Problem

According to research by Wall (2001), obstetric fistula is uncommon in wealthy countries but widespread in Africa and other developing regions. In this part of the world, it is one of the most serious complications of giving birth. According to the World Health Organization (WHO), obstetric fistula affects over two million women and girls worldwide, with the highest prevalence in Africa. In addition, at least 20% of women experience some sort of injury, infection, or disability during childbirth, and over a million babies die each year as a result, according to a report by the United Nations Population Fund from 2010. More than two million women and girls in poor countries are afflicted, and each year brings at least 100,000 new cases (UNFPA, 2010). In light of the WHO report from 2005 and the UNFPA report from 2010, it is clear that the incidence of fistulas is on the rise. Women and girls who suffer from this condition often feel hopeless, and some even experience social stigma as a result.

As a result, many groups have been working to stop this from happening: the Fistula Foundation of Nigeria, the Women's Missionary Society, the World Health Organization, the White Ribbon Alliance, the United Nations Population Fund, Human Right Watch, the International Women's Health Coalition, the United Nations Foundation, Family Care International, and many more.

A significant effort has been made to prevent and control the disease by using the media to raise public awareness. It is the purpose of this research to determine whether or not these public education campaigns have prompted people to make changes for the better. Accordingly, the purpose of this research was to evaluate the impact of public awareness campaigns on the prevalence of obstetric fistula in Nigeria.

1.3 Objectives of the Study

Generally, every research is goal-oriented; the goal must be stated in clear terms to enable its realization. Therefore, the objectives which this study intends to achieve are as follows;

i. To find out the level of exposure of Nigerians on Obstetric Fistula campaigns.
ii. To ascertain the knowledge level of Nigerians on Obstetric Fistula.
iii. To find out their major sources of information.
iv. To ascertain the influence of mass media campaigns on Obstetric Fistula in Nigeria.

1.4 Research Questions

The following research questions are formulated to guide the proper investigation of this study;

i. What is the level of exposure of Nigerians on Obstetric Fistula campaigns?
ii. What is the knowledge level of Nigerians on Obstetric Fistula?
iii. What are their major sources of information?
iv. What is the influence of mass media campaigns on Obstetric Fistula in Nigeria?

1.4 Scope of the Study

This research examined how public awareness initiatives against obstetric fistula in Nigeria have fared in the country's media. The researcher would like to expand the scope of this study beyond Suleja town in Niger State, but doing so would be overly complicated.

1.5 Significance of the Study

This study is significant in the following ways;

- This research will aid in the development of media-based interventions for behaviour change and community information by providing policy and programme formulators with precise demographic information on what the media is already doing.
- It will also provide information to policy and programme managers that can be used to design community-based information and communications activities that help reduce the stigma associated with fistula, change the behaviour of community leaders and the families of fistula sufferers, and eventually lead to the reintegration of fistula patients into their communities and families.
- The study's findings will inform future efforts to involve Nigeria's media in fistula awareness campaigns, as well as new approaches to fistula prevention, treatment, and aftercare, and the reintegration of fistula patients into communities and families.
- The findings of this research will shed insight on the process by which the media in this nation develops campaigns to combat obstetric fistula. The media professional will also benefit from this since they will be able to gauge the success of their campaign.
- Finally, this research will add to the growing body of scholarship on obstetric fistula and related media efforts. This study will be useful as a resource for future researchers in this field or those studying similar topics because of the wealth of literature it contains.

1.6 Limitation of the Study

The researcher would want to examine the impact of media campaigns on obstetric fistula in Nigeria, however doing so would be time-consuming and may prevent the researcher from completing the research in the allotted amount of time. This is why the study focused only on obstetric fistula in Suleja, Niger State, where it has been shown that media campaigns have a significant impact in changing attitudes and behaviours. However, it is clear that the results of this study cannot be extrapolated to all of the northern states in Nigeria.

The language barrier is another obvious shortcoming of this investigation. As such, the researcher is not a native speaker of Hausa. Some respondents required extensive explanations of the questionnaire's purpose and format from the researcher. Some respondents were resistant in providing information the researcher needed because of the sensitive nature of the topic (a serious health concern impacting northern teenage females).

1.7 Definition of Terms

For the purpose of clarity, some key terms used in this study are operationally defined. These terms include:

- Obstetric Fistula: A unpleasant birthing injury, obstetric fistula causes urine and/or faecal incontinence due to an irregular hole between the bladder and the vagina and/or the rectum. Involuntary urination into the vagina is caused by a fistulous abnormality connecting the bladder and the vagina. Every time this happens, the victim's clothes gets wet, causing more injury to the skin around the vagina.
- Mass media: These are the methods by which knowledge about obstetric fistula is disseminated to a big, diverse, unified, and anonymous group of people. Media outlets such as radio, television, print newspapers, and periodicals are all included.
- Campaigns: These are public service announcements designed to educate the residents of Suleja about the risks of Obstetric Fistula and how to look for it and treat it if it does occur.
- Influence: This pertains to how the people of Suleja's outlook, information, and actions have been influenced by the campaigns.



2.1. Review of Relevant Literature

An obstetric fistula is a fistulous abnormality connecting the vagina to the bladder or rectum. The defect enables involuntary and constant passage of urine or faeces into the Vaginal vault (Forsgren, Lundholm, & Johansson, 2009). Villey (2006) describes obstetric fistula as an improper connection between the urinary bladder and the vagina that results in the persistent, involuntary release of urine into the vaginal vault.

According to Zacharin (1988), the vagina was normal but there was a rip in the bladder which joins the vagina when the remains of Queen Henhenit, the wife of King Mentuhotep 11 of Egypt (2050 BC), were unearthed in Cairo in 1923 and subjected to comprehensive clinical investigation. The attending physician reasoned that this must have been the fatal illness that took her life.

The above demonstrates unequivocally that obstetric fistula is not a recent phenomenon anywhere in the world. According to Wall (2001), the development of knowledge and technology, particularly in Europe and North America, has rendered the plague mostly unknown in these places. In Africa, obstetric fistula is a leading cause of maternal mortality. In nations with comprehensive health care that prioritises the wellbeing of women, the prevalence of fistula has decreased to nearly nothing, as noted by Metro (2006). Metro also reported that obstetric complications are a leading cause of obstetric fistula in developing nations. He cited hysterectomy-related anterior bladder damage as the root cause in 90% of such instances.

However, Wall and Lancer (2006) pointed out that there are cases of obstetric fistula in industrialised countries, and that these are often the result of "radiation therapy or surgery thus distinguishing the aetiology from that of developing countries which result mainly from neglect of obstetric compared to that of developed countries, which occur under very different circumstance."

Most discussions about obstetric fistula centre on Africa and this is because Africans are the most affected. In Nigeria alone, according to Villey (2006),

There is an obstetric fistula rate of 350 cases per100,000 deliveries at a University Teaching Hospital. This condition is enormous and thus ravages Nigerian women that the country’s Federal Ministry for Women Affair and Youth Development, has estimated that the number of untreated obstetric fistula in Nigerian stands between 800,000 and 1,000,000.

According to the aforementioned paper, obstetric fistula is a major problem in Nigeria, and only immediate action on the part of the government, international organisations, NGOs, etc., would be able to alleviate the situation. According to Kari (2007), the Nigerian Ministry of Health estimates that 800,000 women, the most majority of whom reside in rural regions, are affected by the problem of obstetric fistula, lending more validity to the aforementioned study. Unfortunately, most of Nigeria's rural communities lack access to adequate medical treatment. Forty percent of the world's cases of obstetric fistula occur in this nation. Some of the sufferers of obstetric fistula are very young and have not even had the opportunity to attend elementary school, and their presence is irritating to everyone around them because of the foul odour that continually emanates from them. A clear picture of the agony victims of obstetric fistula, go through was noted by Matsamura (2004) thus:

Martina Nakamya (not her real name) was having her first baby after having left school at age 16 because of her pregnancy. Preparations were made with the birth attendant in the village. Nakamya’s labour lasted almost four days. When she finally pushed the baby out, it was dead, and Nakamya was not well. She ‘leaked’ and smelled of urine and faeces all day, every day.

"Constant in pains,...ashamed of the terrible stench that comes out of them, abandoned thus by their husbands, outcasts of society, unemployable except in the fields, they survive, they exist without friends and without hope," is how Akpeji (2012) characterises obstetric fistula patients.

When a woman is in labour in Japan, she often stays at home for three days trying to push before being sent to the nearest obstetric centre, as noted by Magashi (2006). According to Magashi, the maternal death rate in Nigeria is 948 per 100,000 live births, with a range of 339 to 1716.

Causes of Obstetric Fistula

Obstetric fistulas are notoriously difficult to attribute to a specific aetiology. However, this research considers the issue from a cultural as well as a physical angle. Direct causes relate to the underlying or contributory factors, whereas indirect causes refer to the physical reasons. However, obstetric fistula symptoms include vaginal discomfort, recurrent UTIs, and persistent flow of urine.


Excerpt out of 45 pages


The Influence of Mass Media Campaigns on Obstetric Fistula in Nigeria
University of Benin
Mass communication
Catalog Number
ISBN (Book)
influence, mass, media, campaigns, obstetric, fistula, nigeria
Quote paper
Glory Edegware (Author), 2022, The Influence of Mass Media Campaigns on Obstetric Fistula in Nigeria, Munich, GRIN Verlag,


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