Mental Health Outcomes and Quality of Life of Survivors of Obstetric Fistula in Katsina State: An Empirical Assessment

Background: Obstetric fistula leaves survivors with profound physical, psychological, and social consequences that extend well beyond surgical repair. Longitudinal mental health outcomes in this population within the North West geopolitical zone of Nigeria remain poorly characterised empirically. This study assesses mental health outcomes and quality of life among surgically repaired obstetric fistula survivors in Katsina State. Methods: A cohort of 120 post-surgical obstetric fistula survivors was prospectively followed at 3 and 12 months post-repair. The Patient Health Questionnaire-9 and the WHO Quality of Life BREF tool were administered at both time points. Paired t-tests and multivariate regression examined predictors of sustained mental health improvement. Results: Depression prevalence was high at 3 months post-repair and declined significantly by 12 months, though a residual proportion met diagnostic thresholds for persistent depression. Social reintegration was the strongest predictor of improved quality of life. Survivors without formal education and those who returned to unsupportive households showed the poorest outcomes. Conclusion: Surgical repair alone is insufficient to address the mental health burden of obstetric fistula in Katsina State. Family medicine-led post-repair psychosocial rehabilitation programmes incorporating structured counselling, vocational support, and community reintegration are essential components of comprehensive care. Keywords: obstetric fistula, mental health, quality of life, Katsina State, rehabilitation