 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Erika Sinclair, Joseph Ruminjo, MD, MPH, and Mary Nell Wegner, EdM, MPH. Maternity and Postabortion Care Program, EngenderHealth, 440 Ninth Avenue, 3rd Floor, New York, NY 10001, 212-993-9846, esinclair@engenderhealth.org
Obstetric fistula (which includes both vesico-vaginal and recto-vaginal fistula) is a critically important and largely neglected issue in the field of reproductive health. It is most often the result of prolonged and obstructed labor, and occurs when the soft tissues of the mother’s vagina and bladder and/or rectum are pressed between the fetal skull and the mother’s pelvis. This pressure, over a long period of time, cuts off the blood supply to the tissues, causing necrosis. A fistula—or hole—is then left between the woman’s vagina and bladder, or vagina and rectum, or both, causing her to leak urine and/or feces without control. The World Health Organization estimates that at least 2 million girls and women currently live with fistula and an additional 50-100,000 are affected each year. For the vast majority of these girls and women, cultural, social, and geographic constraints make services to repair the condition out of reach.
To begin to understand how best to address the universe of possible strategic interventions, a needs assessment (led by EngenderHealth and supported by a grant from UNFPA HQ) – covering Benin, Chad, Malawi, Mali, Mozambique, Niger, Uganda, Zambia, Malawi, and Mozambique—was conducted to provide a snapshot of how some clinical services for fistula clients have been organized. The assessment was carried out during a series of site visits in each of the 9 countries. A simple, nine question survey instrument was used to interview administrators and professional staff, as well as fistula clients, whenever possible.
Learning Objectives:
Keywords: Maternal Morbidity, Labor
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.