Incidence and Risk Factors of Vesico-Vaginal Fistula Among Women at National Obstetric Fistula Centre, Babbar Ruga, Katsina

Obstetric vesico-vaginal fistula (VVF) is a devastating childbirth injury causing chronic urinary incontinence, social isolation, and psychological trauma, with Nigeria accounting for approximately one-third of the global burden. This study examines the incidence, risk factors, and sociodemographic profile of VVF patients at the National Obstetric Fistula Centre (NOFIC), Babbar Ruga, Katsina State, North West Nigeria. A cross-sectional review of patient records from 2020 to 2023 was conducted, supplemented by structured interviews with 100 consenting fistula patients. Data on age at fistula occurrence, labour history, educational level, parity, and prior surgical repair were collected. Mean age at fistula occurrence was 18.4 years, with 62 percent of cases occurring in teenagers. Prolonged obstructed labour exceeding 24 hours was the precipitating event in 89 percent. Home delivery with traditional birth attendant (78 percent) and no antenatal care (54 percent) were almost universal antecedents. Early marriage before age 18 years was documented in 74 percent of affected women. Previous failed fistula repair was noted in 34 percent. The study identifies adolescent marriage, home delivery, and lack of antenatal care as the convergent risk factors for VVF in Katsina. Recommendations include enforcement of child marriage legislation, community transport funds for obstetric emergencies, and scale-up of trained midwife coverage in Katsina rural LGAs. Keywords: vesico-vaginal fistula, obstetric fistula, Katsina State, obstructed labour, adolescent marriage