Are 6 million Kenyan women currently suffering from obstetric fistula?

Do one in four women in Kenya suffer from fistula as a recent report suggests?

A recently published report by Amref Health Africa on the prevalence of obstetric fistula in Kenya estimates that more than 6 million women in Kenya suffer from the condition, which is caused by prolonged or obstructed labour.

Obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman incontinent of urine or feces or both. Women who experience the condition suffer shame, social segregation and health problems from the constant incontinence.

Data on the prevalence of obstetric fistula in East Africa is largely outdated, relying on small statistical samples to approximate how many women in the general population suffer from the condition. As a result, it is difficult to determine the scope of the condition in order to put treatment and prevention measures in place.

So the question is, do one in four Kenyan women suffer from fistula?

PesaCheck looked into the claim published by Amref Health Africa that 6 million Kenyan women suffer from fistula and finds it to be FALSE for the following reasons:

The World Health Organization estimates that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa, with 50 000 to 100 000 new cases recorded each year.

According to the 2017 Statistical Abstract, 918,829 births were reported in 2016, with an estimated 500,000 births going unreported, putting the total number of births at approximately 1.4 million.

The Fistula Foundation estimates that 4 deliveries out of every 1,000 in Kenya result in fistula, and going by the total number of births, there are 56,000 new fistula cases every year. According to the Flying Doctors Organization, only 7.5 percent of mothers with fistula are able to access medical care for the condition.

A 2004 UNFPA estimate puts the backlog of those living with untreated fistula at approximately 300,000 cases, but this data is old and therefore unreliable when it comes to estimating the current prevalence of fistula.

According to the Fistula Foundation, the root causes of fistula are grinding poverty and the low status of women and girls. Poverty and malnutrition in children leads to stunting and underdevelopment of the skeleton. In girls, this affects the development of the pelvis, contributing to obstructed labor later in life, which is a major cause of fistula.

Data from UNICEF shows that the adolescent birth rate in Kenya as at 2013 was 101 births for every 1,000 girls aged between 15 and 19, the age-group is most susceptible to fistula.

Kenya has an estimated 14.6 million women aged 15 and above, and this is the population most likely to ever have given birth.

Taking this figure, and the estimate of 6 million women suffering from fistula put forward by Amref Health Africa, the implication is that 41% of women have the condition, far higher than the 1% figure put forward in the 2014 Kenya Demographic and Health Survey.

Therefore, the claim by Amref Health Africa that 6 million women in Kenya suffer from fistula is therefore FALSE, as the figures show that the number of women suffering from the condition is approximately 300,000.

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This report was written by Wahu Wainainah, a Kenyan business journalist and member of the WanaData network of women data journalists, and edited by PesaCheck managing editor Eric Mugendi. The infographics are by Eunice Magwambo, a Kenyan graphic designer, visual artist and digital content producer.

PesaCheck, co-founded by Catherine Gicheru and Justin Arenstein, is East Africa’s first fact-checking initiative. It seeks to help the public separate fact from fiction in public pronouncements about the numbers that shape our world, with a special emphasis on pronouncements about public finances that shape government’s delivery of public services linked to the ‘Sustainable Development Goals’ (SDGs) , such as healthcare, rural development, and access to water and sanitation. PesaCheck also tests the accuracy of media reportage. To find out more about the project, visit pesacheck.org.

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PesaCheck is a joint initiative of Code for Africa, through its local Code for Kenya chapter, and the International Budget Partnership (Kenya), in partnership with a coalition of local media organisations, with additional support from the International Center for Journalists(ICFJ).

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