Effectiveness of Educational Programs in Preventing Vesicovaginal Fistula Recurrence in Northern Nigerian Women: A Community-Based Randomised Controlled Trial

Abstract

Background: Vesicovaginal fistula (VVF) remains a significant reproductive health challenge in Northern Nigeria, often resulting from prolonged obstructed labour and inadequate obstetric care. While surgical repair restores anatomical integrity, recurrence is common due to limited awareness of preventive practices and poor post-repair follow-up. Aim: This study evaluated the effectiveness of a structured community-based educational program in preventing VVF recurrence among women post-repair. Methods: A community-based randomised controlled trial was conducted among 200 women successfully repaired of VVF in three Northern Nigerian states. Participants were randomly assigned to two groups: intervention (n = 100), who received a six-month structured educational program on maternal health, reproductive hygiene, and safe childbirth practices, and control (n = 100), who received routine post-repair counselling only. Follow-up assessments were conducted at 3 and 6 months post-intervention to evaluate recurrence rates, knowledge retention, and adherence to preventive measures. Data were analysed using SPSS version 27, with significance set at p < 0.05. Results: At 6 months, VVF recurrence was significantly lower in the intervention group (2%) compared to the control group (10%) (p = 0.018). Participants in the intervention group demonstrated markedly improved knowledge of reproductive health practices, adherence to antenatal care attendance, and avoidance of high-risk childbirth settings. Multivariate logistic regression identified participation in the educational program as an independent predictor of reduced recurrence (AOR = 0.21, 95% CI: 0.05–0.86). Conclusion: Community-based educational interventions are effective in reducing VVF recurrence and improving reproductive health awareness among Northern Nigerian women. Integrating structured education into post-repair follow-up programs can strengthen prevention strategies, enhance quality of life, and contribute to the long-term elimination of obstetric fistula in resource-limited settings.