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8 J. Int'l Humanitarian Action 1 (2023)

handle is hein.journals/jinthuma8 and id is 1 raw text is: Adjorlolo etal. Journal oflnternational Humanitarian Action (2023) 8:1 https://doi.org/10.1186/s41018-022-00133-y Journal of International Humanitarian Action Obstetric fistula-induced incontinence and WASH programming in humanitarian settings: agenda for research, innovation, and practice Samuel Adjorlolo Mary Ani-Amponsah3, Emily Hammond4 and Maame Esi Pantsiwaa Nyame5 Abstract Women living with obstetric fistula-induced incontinence (OFII) have heightened need for water, sanitation and hygiene (WASH) services because they experience involuntary leaking of urine, feces, or both. In humanitarian set- tings where access to WASH services is notably limited, research and innovation relating to OFII and WASH program- ming has not been granted the requisite attention, relative to menstrual hygiene management. The paper is intended to bring to the attention of humanitarian researchers and practitioners the research needs of women living with OFII. Three thematic areas that have the propensity to arouse interest in this neglected topical issue and help to set the stage for research and actions are discussed.These are the prevalence of OFII, prevention of OFII, and WASH program- ming for women living with OFII. Empirical studies dedicated to the above thematic issues will generate the needed evidence base to inform decision-making processes relating to improving the WASH needs of women living with OFII. Keywords: Obstetric fistula, Incontinence, Humanitarian, Emergency, WASH Background Researchers, policy-makers, and practitioners have expressed profound interest in the provision of water, sanitation, and hygiene (WASH) services in humanitarian settings through the development and implementation of several innovative products and services, including care guidelines (Brown et al. 2012; Giles-Hansen 2015; Vujcic et al. 2015). Within the general humanitarian population is a subset of vulnerable women who have heightened need for WASH services because they expe- rience incontinence, referred to as involuntary loss of urine and/or feces. One of the notable causes of incon- tinence is obstetric fistula (OF), defined as the formation of a hole between the vagina and bladder (vesico-vaginal *Correspondence: sadjorlolo@regig.org Research and Grant Institute of Ghana, Legon Post Office, Agbawe Avenue 22, P.O. Box FG 1004, AdentanAccra, Accra, Ghana Full list of author information is available at the end of the article SSpringer Open fistula), vagina and rectum (recto-vaginal fistula), or both (Lufumpa et al. 2018; Rosato-Scott and Barrington 2018; Tayler-Smith et al. 2013). OF often results from obstructed labor caused by a mismatch between the size of the fetus and birth canal (Wall 2006) and lack of access to emergency care, such as caesarean section. Obstructed labor induces pressure on the tissues of the bladder, vagina and rectum, leading to inadequate blood supply and death of tissues (Bashah et al. 2018). Although OF has been eradicated in high income countries, where 'a mismatch between fetal head and pelvis is rapidly rec- ognized and managed correctly (Lufumpa et al. 2018), it is one of the major challenges facing women in low and resource constrained settings (Rosato-Scott and Bar- rington 2018; Tayler-Smith et al. 2013). Sexual offenses such as rape against underaged women or pregnant women could contribute to OF, These social vices are very common in humanitarian settlements. O The Author(s) 2022. Open Access This artide is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium orformat, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.The images or other third party material in this article are incuded in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not incuded in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.or/licenses/by/4.0/. RESEARCH ARTICLE Open Access

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