Table 1.

Background, methodological details and key findings of the included studies

S. No	Author (s) and year of publication	Location of study	Research objectives	Study design and time	Sample method of recruitment and participants’ characteristics	Main findings	Quality rank
1	Kabir et al. (2003)	Muritala Muhammed Specialist Hospital, Kano	To assess the consequences of vesico-vaginal fistula among women presented with vesico-vaginal fistula	Cross-sectional study, use of structured questionnaire; November to December 2001	120 women with vesico-vaginal fistula were sampled but the sampling technique was not specified. The age distribution of the women includes 10–15 (n = 98), 16–20 (n = 18), 20–25 (n = 4)	More than half of the women (n = 61) were bitter about their condition, almost half of the women (n = 40) were depressed while a minority of the women (n = 9) were indifferent No psycho-social support was reported	Low
2	Hassan and Nasir (2019)	Maryam Abacha Fistula Hospital, Sokoto	To determine the frequencies of the common comorbidities in patients managed for obstetric fistula	Prospective cross-sectional study; use of Beck’s inventory	A total of 179 patients including married women (n = 155), widows (n = 4) and divorcees (n = 20) were sampled. Their age distribution comprised of 14–19 (n = 50), 20–24 (n = 43), 25–29 (n = 27) and more than 30 years (n = 59). A total of 92.7% (n = 166) had no formal education, 4.5% (n = 8) had just primary education while 2.8% (n = 5) had secondary education. However, the method of recruiting the participants was not stated	A total of 106 (59.2%) had foot drop and approximately 58.1% of the participants (n = 104) were reported to be depressed. No psycho-social support was recorded	Low
3	Nsemo (2014)	Family Life Centre and Hospital, Mbribit Itam, Akwa Ibom state	To assess the extent to which abandonment, social isolation and stigmatisation significantly influence the coping strategies of women affected by vesicovaginal fistula	Cross-sectional study with the use of structured and unstructured interview. Time of the research was not recorded	A total of 120 women seeking treatment from the obstetric fistula centre were sampled through purposive sampling. Majority of the women (n = 80) were divorced while 27.50% (n = 33) were still married. Most of the women (n = 40) were primary school leavers while about 31.79% (n = 38) stopped at secondary education	While a minority of the women received support from their families and spouse, most of the women were abandoned and rejected by their spouses. While some of the women were stigmatised, some were filled with fear. Some of the women were isolated from their co Also, the abandonment and stigmatisation they experienced negatively affected their coping abilities	Moderate
4	Nweke and Igwe (2017)	National Obstetric Fistula Centre, Abakaliki, Ebonyi state	To explore the psycho-social experiences of patients with vesicovaginal fistula	Cross-sectional study; focus group discussions. No time frame was recorded	100 women were sampled. Majority of the women (n = 95) were rural dwellers while more than half of the women (n = 54) were without a formal education. The age distribution included 16–25 (n = 14), 26–35 (n = 40), 36–45 (n = 27), 45 years and more (n = 19). The sampling technique used was not recorded	Psycho-social impact on the participants included helplessness, sadness, suicidal thoughts, stigma and blame, feeling of worthlessness, fear of divorce, shame and social withdrawal and perinatal loss. Social support received by a minority of the women (n = 33) was recorded	Low
5	Fehintola et al. (2019)	Obstetric fistula unit of Obstetrics and Gynaecology department of Obafemi Awolowo University Teaching Hospital Complex, Ilesha, Osun state	To examine the medical and psycho-social consequences of obstetric fistula on the patients	Cross-sectional study with structured interviews and focus group discussions between July 2017 to December 2018	A total of 86 patients with ages including 15–24 (n = 15), 25–34 (n = 40), 35–44 (n = 18), 45–54 (n = 10), more than 55 (n = 3) were sampled through purposive sampling	A divorce rate of 40% was reported among the patients. About 38.4% (n = 33) of the patients were depressed, 19.8% (n = 17) had lost their self-esteem, 75.6% (n = 65) felt ostracised, 52.3% (n = 45) were bitter and 37.2% (n = 32) were isolated due to shame. Infertility was recorded in 19.8% (n = 17) while perinatal loss was experienced in 85% of the respondents. Social support which included consolation and encouragement were reported in a few patients	Moderate
6	Degge et al. (2019)	Evangel Vesico-Vaginal Fistula (EVVF) centre, Bingham University Teaching Hospital, Jos	To understand the identities fistula survivors, ascribe to themselves and explore the impact of these identities through the process of their illness experiences	Narrative inquiry with an episodic narrative interview. No time frame recorded	15 women who were previously with obstetric fistula, undergone repair, rehabilitated and were re-integrating into their communities were recruited using purposive sampling	The women experienced shame, psychological trauma, loss of self-worth, despair, identity change, stigma, divorce, sense of hopelessness, suicidal thoughts. Rehabilitation program was reportedly available for women with obstetric fistula	High
7	Okoye, Emma-Echiegu and Tanyi (2014)	National Fistula Centre, Abakaliki, Ebonyi state	To explore the lived experiences of vesicovaginal fistula victims and their coping strategies	Cross-sectional study with taped interview in October 2010	10 women awaiting obstetric fistula repair were sampled through purposive sampling. The mean age of these women was 35 years. Only 3 of the women were still married while only 1 lacked formal education	The studied women were ostracised by their families, spouse and communities, shamed and depressed. Loss of self-esteem, perinatal loss, stress and anxiety were also reported among the respondents. Psycho-social support from families was reported	Low
8	Emma-Echiegu, Okoye and Odey (2014)	National Fistula Centre, Abakaliki, Ebonyi state	To examine the knowledge of causes of vesicovaginal fistula on vesicovaginal fistula patients and explore experiences of stigma and discrimination of vesicovaginal fistula	Cross-sectional study with focus group discussions between August and December 2011	30 women between the ages of 15 to 65 were sampled through purposive sampling. A total 33.3% (n = 10) had no formal education while only 20% (n = 6) attained secondary education. Most of the women (n = 14) were divorced while 13.3% (n = 4) were never married	Divorce, loss of child, depression, stigma, discrimination and social isolation were reported among the studied women. No psycho-social support was reported	Low