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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

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

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

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
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