Post-Surgical Outcomes and Social Reintegration Experiences of Women with Obstetric Fistula in Northwest Cameroon. A Mixed-Methods Evaluation

Background: Obstetric fistula remains a significant cause of maternal morbidity in sub-Saharan Africa, with long-term physical, psychosocial, and economic consequences. Evidence on integrated recovery outcomes in Cameroon is limited. The aim of this study was to evaluate clinical, psychosocial, and economic outcomes among women treated for obstetric fistula within the Cameroon Baptist Convention Health Services. Methods: A mixed-method design was used to evaluate the experiences of 29 women who had undergone obstetric fistula repair and completed a minimum of six months of follow-up at Mbingo Baptist Hospital. Quantitative data on socio-demographics, fistula type, continence status, and surgical history were analysed descriptively and using chi-square and logistic regression tests. Qualitative data from in-depth interviews conducted between September and November 2024 were analyzed thematically to explore lived experiences of recovery and reintegration. Results: Most participants (72.4%) had vesicovaginal fistula. At discharge, 93.1% were continent; at six-month follow-up, 82.8% reported no leakage. No significant association was found between fistula type and continence at discharge (χ² = 0.82, p = 0.845). The median monthly income was $50 (IQR: $25–$90), and participants had a median of two surgeries (IQR: 1–3). Twelve qualitative themes emerged, including restoration of physical health, respectful care, emotional renewal, family support, community solidarity, persistent stigma, economic disruption, empowerment through livelihood support, leadership, and aspirations for the future. Conclusion: While high rates of anatomical closure and continence were achieved, sustained recovery depended on comprehensive care extending beyond surgery. Respectful treatment, psychosocial counselling, family engagement, community sensitization, and economic empowerment were central to successful reintegration. Fistula care programs should adopt integrated approaches that combine clinical and social models of care, tailored to the specific contexts in which they are implemented