Current gaps and the way forward for obstetric fistula in Nigeria

Obstetric fistula is a devastating maternal health condition that continues to affect millions of women worldwide each year. It is associated with severe physical, psychological, social, and economic consequences, making it a persistent public health challenge, particularly in low-resource settings. Although previous research has identified numerous risk factors associated with obstetric fistula, important gaps remain in understanding unmet needs in prevention, treatment, and care, as well as where interventions are most needed, particularly in Nigeria. Furthermore, few studies have applied a conceptual framework to systematically examine the multiple environmental, sociocultural, health care, and individual factors contributing to obstetric fistula and to identify opportunities for intervention across the continuum of care. In this non-systematic narrative review, a proposed conceptual framework was used to organize the factors associated with obstetric fistula, identify unmet needs, and highlight gaps in existing interventions. The findings suggest that current prevention strategies do not adequately address several key determinants of obstetric fistula and underscore the need for more comprehensive, context-specific interventions. Strengthening preventive education, improving access to affordable, high-quality obstetric care, and addressing the broader social determinants of maternal health are essential to accelerating the elimination of obstetric fistula in Nigeria.