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We are aware of four population-based studies that examined determinants of VF [].

These studies only included a small number of surveys, assumed that self-reports of VF symptoms were perfectly accurate, and none pooled surveys together, severely limiting their statistical power.

Being able to read decreased the odds of VF by 13 % (95 % Credible Intervals (Cr I): 1 % to 23 %), while higher odds of VF symptoms were observed for women of short stature ( Increasing literacy, delaying age at first sex/birth, and preventing sexual violence could contribute to the elimination of obstetric fistula.

Concomitant improvements in access to quality sexual and reproductive healthcare are, however, required to end fistula in sub-Saharan Africa. Of all maternal morbidities, obstetric fistula is one of the most debilitating conditions with the immediate consequence of chronic urinary and/or fecal incontinence.

You can speak openly without giving up any control over your situation.

These units will not report your concerns to anyone else, and they will not take action toward resolving your concerns without your consent.

DHS and MICS surveys conducted in sub-Saharan Africa that included questions about VF symptoms were considered for this analysis.

A comprehensive overview of DHS and MICS surveys can be found elsewhere [].

The specific questions related to vaginal fistula symptoms varied slightly from survey to survey and a contingency question about knowledge of vaginal fistula was sometime incorporated.The vast majority of VF in sub-Saharan Africa are of obstetric origins and prevalence of this condition in this region was recently estimated to be between 1.0 and 1.6 per 1,000 women of reproductive age depending on methodology [].The numerous clinical series usually report socio-demographic characteristics of VF patients (age of marriage, marital status, literacy, parity, etc.) as well as circumstances of fistula occurrence (duration of labor, type of birth attendance, mode and place of delivery, etc.) []: delay in decision to seek care, delay in reaching care, and delay in receiving adequate care once in the health facility.VF of obstetric origin are caused by an intertwined set of biological, socio-economic, and cultural factors that favor obstructed labor and triggered by insufficient or delayed access to quality emergency obstetric care [].

VF of traumatic origin mostly results from sexual violence.Since 2004, these surveys progressively began to include questions about VF symptoms.