DOCSLIB.ORG

Experiences of Women with Obstetric Fistula in Nigeria: a Narrative Inquiry

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Experiences of Women with Obstetric Fistula in Nigeria: a Narrative Inquiry THE UNIVERSITY OF HULL Experiences of Women with Obstetric Fistula in Nigeria: A Narrative Inquiry A Thesis Submitted to the University of Hull in Fulfilment of the Award of Degree of Doctor of Philosophy in Health Studies By Hannah Mafo Degge MPH (2011) University of Leeds, UK April 2018 DEDICATION In loving memories of my beloved husband, Abraham Degge (who believed in me and set me on the path to doing a PhD) and my beloved son Boyesoko Degge (too wonderful a son to be forgotten) And to the brave women, who shared their stories- “A voice to make maternal healthcare accessible to all” ii ACKNOWLEDGEMENT The PhD journey has been a long and hard journey that would have been impossible to achieve without the kindness, support and encouragement of numerous people. First and foremost, I sincerely and deeply appreciate my supervisors, Prof Mark Hayter and Dr Mary Laurenson, for their thorough and relentless guidance, support and encouragement all through the study process. I acknowledge with deep gratitude Dr Moira Graham, Research Director, Faculty of Health Sciences for your ceaseless words of encouragement and support. I wish to also acknowledge the support of EVVF centre, BHUTH, and particularly the director, Dr Sunday Lengmang for the encouragement and sustained motivation to do this research. My parents Chief and Mrs. Andrew Aileku OFR, my brothers and sisters and their families, who stood solidly behind me in this journey. I sincerely appreciate your prayers, support and encouragement, that kept me moving on throughout the study period. My PhD colleagues who became like a family to me, too numerous to mention, I appreciate the support and encouragements of Sheena McRae, Love Onuorah, Yetunde Atayeiro, Franklin Onwukgha, and Peninah Agaba, challenging me to keep moving forward. I sincerely appreciate special friends that stood by me worthy of mention: Prof Leonard Fwa, for believing I could make it and supporting me through this journey, Pat and Abraham Otsapas, Fadeke and Abraham Awobem, James and Rose Masamha, and my Jubilee family; for taking my boys and I into your families and doing all your best to make our stay in UK a wonderful one, I am deeply grateful. And I am grateful to friends who have become more like sisters-Lily Asare, Blessing Eseke, Bimpe Oyeyipo, Tope Eboigbe, Ngozi Olulana, Christy Fola-Toluhi, Akpos Osim, Marion Osuide, Dorcas Omeire holding my hands, praying for me, ever ready to listen, encourage and assist my family. And to my beloved sons, Ayemlo and Nimmo Degge, for being such loving and wonderful children; for supporting me all these years of my academic pursuit and bearing the brunt of having a ‘studying mum’, I am deeply grateful it all helped greatly to make this a reality. iii ABSTRACT Obstetric Fistula is an abnormal opening between the vagina and rectum resulting from prolonged and obstructed labour. It occurs mostly in developing countries and is a neglected maternal health issue in Nigeria. Women’s experiences of living with fistula often reflect gender inequities. This study explored how women attending a reintegration service described their experiences of living with fistula. Using narrative inquiry methodology, 15 women (treated and rehabilitated) were interviewed. Data were analysed using the core story creation and emplotment method of narrative analysis. A reconstructed narrative provided plot headings of ‘fistula ordeal, treatment process, and returning to life’. Fistula formation was linked to the influence of others, geographical remoteness and transport and poor health systems. Fistula survivors and families facilitated access to treatment; aided to cope with incontinence that triggered stigma issues. Negative identity changes through incontinence were: ‘Leaking’ identity, ‘Masu yoyon fitsari’ (the leakers of urine identity), and ‘spoiled’ identity. Attending the repair centre conferred hope and relief through mutual survivors (‘Masu yoyon fitsari’) support. ‘Spoiled’ identity reflected the challenges of the ‘leaking’ identity in the face of ‘failings’ as a woman with respect to sexual and reproductive responsibilities. Reversing the negative identities was pivotal in the women’s resilience in seeking a cure. The ‘improved’ identity achieved after fistula repair and rehabilitation provided continence control and improved financial status. This research is the first known comprehensive empirical study of the experiences of treated and rehabilitated obstetric fistula survivors in Nigeria. The prevalence of fistula in Nigeria reflects inequitable distribution of health care compounded by socio-cultural practices. This research is the first application to women’s health in the African context using Frank’s narrative typology. The study contributes to the empirical evidence of women’s pathway through developing fistula, to treatment, and rehabilitation into family and community life in Nigeria. iv TABLE OF CONTENT DEDICATION ................................................................................................................................... ii ACKNOWLEDGEMENT ................................................................................................................... iii ABSTRACT ...................................................................................................................................... iv TABLE OF CONTENT ....................................................................................................................... v LIST OF ABBREVIATIONS .............................................................................................................. xii RESEARCH/ PUBLICATIONS ......................................................................................................... xiii CHAPTER ONE ............................................................................................................................... 1 INTRODUCTION AND BACKGROUND TO STUDY ........................................................................... 1 1.0 Introduction to Chapter ................................................................................................ 1 PART A: Introduction of Study ................................................................................................. 1 1.1 Thesis Overview .................................................................................................................. 1 1.2 Rationale for Study ............................................................................................................. 3 PART B: Research Context ........................................................................................................ 6 1.3 Maternal Health Issues in Developing Countries ................................................................ 6 1.4 Maternal Morbidity/Complications .................................................................................... 8 1.5 Obstetric Fistula a Public Health Problem ........................................................................ 12 1.5.0 What is Obstetric Fistula? .......................................................................................... 12 1.5.1 Demographic Characteristics of Women with Obstetric Fistula ................................ 13 1.5.2 Causes of Obstetric Fistula in Developing Countries ................................................. 14 1.5.3 Consequences of Obstetric Fistula ............................................................................. 18 1.5.4 Classification of Fistula ............................................................................................... 19 1.5.5 Epidemiology of Obstetric Fistula .............................................................................. 20 1.5.6 Role of Health System in Obstetric Fistula Development .......................................... 21 1.5.7 Prevention of Obstetric Fistula .................................................................................. 24 1.5.8 Treatment of Obstetric Fistula ................................................................................... 29 1.5.9 Social Reintegration of Treated Women .................................................................... 33 1.6 Study Setting- Nigeria ....................................................................................................... 36 v 1.6.0 Country Brief; History, Geography and Economy ...................................................... 36 1.6.1 Maternal Health and Development ........................................................................... 38 1.7 Obstetric Fistula in Nigeria ................................................................................................ 43 1.7.0 Prevalence and Incidence of Fistula ........................................................................... 43 1.7.1 Risk Factors for Obstetric Fistula Development in Nigeria ........................................ 44 1.7.2 Treatment and Prevention Programs in Nigeria ........................................................ 47 1.7.3 Rehabilitation and Reintegration Program ................................................................ 50 1.7.4 Community Participation and Social Reintegration ................................................... 52 1.8 Conclusion of Chapter ................................................................................................. 53 CHAPTER TWO ............................................................................................................................ 55 LITERATURE REVIEW
Load more

Recommended publications
  • Contemporary Issues in Obstetric Fistula
    CLINICAL OBSTETRICS AND GYNECOLOGY Volume 00, Number 00, 000–000 Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. Contemporary Issues in Obstetric Fistula L. LEWIS WALL, MD, DPHIL,*† ITENGRE OUEDRAOGO, MD,‡ and FEKADE AYENACHEW, MD§ *Department of Anthropology, College of Arts and Sciences; †Department of Obstetrics and Gynecology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri; ‡Association Renaissance Arena, Ouagadougou, Burkina Faso; Danja Fistula Center, Danja, Niger; and §International Fistula Alliance, Terrewode Women’s Community Hospital, Soroti, Uganda Abstract: We discuss a variety of contemporary issues connected: for example, a vesicovaginal relating to obstetric fistula. These include definitions of fistula is an abnormal opening between these injuries, the etiologic mechanisms by which fistulas occur, the role of specialist fistula centers in diagnosis the bladder and the vagina. and management, the classification of fistulas, and the Fistulas arise in different ways. A small assessment of surgical outcomes. We also review the number of fistulas are congenital, arising growing need for complex reconstructive surgical pro- from defects that occur during embryog- cedures, follow-up challenges, and the transition to a enesis.1 More commonly, however, fistu- fistula-free world in which other pathologies (such as 2,3 pelvic organ prolapse) will be of increasing importance. las are caused by trauma. Finally, we discuss the need to develop responsive The most common fistulas occurring in systems of maternal health care that treat women with females are genitourinary fistulas (vesico- competence, compassion, respect, and fairness. vaginal fistula, urethrovaginal fistula, Key words: obstetric fistula, vesicovaginal fistula, ’ ureterovaginal fistula, etc.) and genito- obstructed labor, women s rights enteric fistulas (especially rectovaginal fistula).
    [Show full text]
  • Obstetric Fistula Guiding Principles for Clinical Management and Programme Development
    Obstetric Fistula Guiding principles for clinical management and programme development Making Pregnancy Safer World Health Organization Contents Akcnowledgement iii Preface v Section I vii 1 Introduction 1 2 Principles for the development of a national or sub- national strategy for the protection and treatment 7 Annex A: Recommendationss on training from the Niamey meeting 22 Annex B: Recommendations on monitoring and evaluation of programmes from the Niamey meeting (2005) 25 Section II 27 3 Clinical and surgical principles for the management and repair of obstetric fi stula 29 Annex C: The classifi cation of obstetric fi stula 37 4 Principles of nursing care 39 Annex D: Patient card 45 5 Principles for pre and post operative physiotherapy 47 6 Principles for hte social reintegration and rehabilitation of women wh have had an obstetric fi stula repair 53 III Acknowledgments Editors: Gwyneth Lewis, Luc de Bernis, Fistula Manual Steering Committee established by the International Fistula working group: Andre De Clercq, Charlotte Gardiner, Ogbaselassie Gebream- lak, Jonathan Kashima, John Kelly, Ruth Kennedy, Barbara E. Kwast, Peju Olukoya, Doyin Oluwole, Naren Patel, Joseph Ruminjo, Petra Ten Hoope, We are grateful to the following people for their advice and help with specifi c chapters of this manual: Chapter 1: Glen Mola, Charles Vangeenderhuysen Chapter 2: Maggie Bangser, Adrian Brown, Yvonne Wettstein Chapter 3: Fistula Surgeons: Andrew Browning, Ludovic Falandry, John Kelly, Tom Raassen, Kees Waaldijk, Ann Ward, Charles-Henry Rochat, Baye Assane Diagne, Shershah Syed, Michael Breen, Lucien Djangnikpo, Brian Hancock, Abdulrasheed Yusuf, Ouattara Chapter 4: Ruth Kennedy Chapter 5: Lesley Cochrane Chapter 6: Maggie Bangser, Yvonne Wettstein Additional thanks are due to: France Donnay, Kate Ramsey, Claude Dumurgier, Rita Kabra, Zafarullah Gill.
    [Show full text]
  • Prevalence & Factors Associated with Chronic Obstetric Morbidities In
    Indian J Med Res 142, October 2015, pp 479-488 DOI:10.4103/0971-5916.169219 Prevalence & factors associated with chronic obstetric morbidities in Nashik district, Maharashtra, India Sanjay Chauhan, Ragini Kulkarni & Dinesh Agarwal* Department of Operational Research, National Institute for Research in Reproductive Health (ICMR), Mumbai & *United Nations Population Fund, New Delhi, India Received February 20, 2014 Background & objectives: In India, community based data on chronic obstetric morbidities (COM) are scanty and largely derived from hospital records. The main aim of the study was to assess the community based prevalence and the factors associated with the defined COM - obstetric fistula, genital prolapse, chronic pelvic inflammatory disease (PID) and secondary infertility among women in Nashik district of Maharashtra State, India. Methods: The study was cross-sectional with self-reports followed by clinical and gynaecological examination. Six primary health centre areas in Nashik district were selected by systematic random sampling. Six months were spent on rapport development with the community following which household interviews were conducted among 1560 women and they were mobilized to attend health facility for clinical examination. Results: Of the 1560 women interviewed at household level, 1167 women volunteered to undergo clinical examination giving a response rate of 75 per cent. The prevalence of defined COM among 1167 women was genital prolapse (7.1%), chronic PID (2.5%), secondary infertility (1.7%) and fistula (0.08%). Advancing age, illiteracy, high parity, conduction of deliveries by traditional birth attendants (TBAs) and obesity were significantly associated with the occurrence of genital prolapse. History of at least one abortion was significantly associated with secondary infertility.
    [Show full text]
  • Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities
    Journal of Clinical Medicine Review Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities M-Grace Knuttinen *, Johnny Yi ID , Paul Magtibay, Christina T. Miller, Sadeer Alzubaidi, Sailendra Naidu, Rahmi Oklu ID , J. Scott Kriegshauser and Winnie A. Mar ID Mayo Clinic Arizona; Phoenix, AZ 85054 USA; [email protected] (J.Y.); [email protected] (P.M.); [email protected] (C.T.M.); [email protected] (S.A.); [email protected] (S.N.); [email protected] (R.O.); [email protected] (J.S.K.); [email protected](W.A.M.) * Correspondence: [email protected]; Tel.: +480-342-1650 Received: 11 March 2018; Accepted: 16 April 2018; Published: 22 April 2018 Abstract: Colovaginal and/or rectovaginal fistulas cause significant and distressing symptoms, including vaginitis, passage of flatus/feces through the vagina, and painful skin excoriation. These fistulas can be a challenging condition to treat. Although most fistulas can be treated with surgical repair, for those patients who are not operative candidates, limited options remain. As minimally-invasive interventional techniques have evolved, the possibility of fistula occlusion has enriched the therapeutic armamentarium for the treatment of these complex patients. In order to offer optimal treatment options to these patients, it is important to understand the imaging and anatomical features which may appropriately guide the surgeon and/or interventional radiologist during pre-procedural planning. Keywords: colorectal-vaginal fistula; fistula; percutaneous fistula repair 1. Review of Current Literature on Vaginal Fistulas Vaginal fistulas account for some of the most distressing symptoms seen by clinicians today. The symptomatology of vaginal fistulas is related to the type of fistula; these include rectovaginal, anovaginal, colovaginal, enterovaginal, vesicovaginal, ureterovaginal, and urethrovaginal fistulas, with the two most common types reported as being vesicovaginal and rectovaginal [1].
    [Show full text]
  • Obstetric Recto-Vaginal Fistula: What Technique to Use?*
    Open Journal of Obstetrics and Gynecology, 2013, 3, 441-444 OJOG http://dx.doi.org/10.4236/ojog.2013.35081 Published Online July 2013 (http://www.scirp.org/journal/ojog/) Obstetric recto-vaginal fistula: What technique to use?* Sanaa Errarhay#, Samia Mahmoud, Najia Hmidani, Hanane Saadi, Chahrazed Bouchikhi, Abdelaziz Banani Department of Gynecology and Obstetrics, CHU Hassan II, Fez, Morroco Email: #[email protected] Received 25 May 2013; revised 22 June 2013; accepted 29 June 2013 Copyright © 2013 Sanaa Errarhay et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT fibrosis zone then the suture of the rectum and the va- gina. Objective: The recto-vaginal fistula is an abnormal communication between the previous wall of the rec- 2. OBSERVATION NO. 1 tum and the posterior face of the vagina through the recto-vaginal septum. They are often due to the ob- It is about a multifarious 55-year-old patient, without stetric traumas and they can be of post-surgical ori- considerable pathological histories. All the deliveries gin. Methods: We report five cases of patients with took place at home with non-specified born weights. The obstetric recto-vaginal fistula and all of the patients patient reports since her marriage, 40 years ago, the have surgical intervention with a resection of the fis- stemming of the stools by the vagina. The gynecological tulous route and rectal wall. Results: The patient did examination objectified, by the speculum and in the rec- not present any recidivating and the evolution is sat- tal touch combined to the vaginal touch, a solution of isfactory without complications or recidivating.
    [Show full text]
  • Obstetric Fistula: the Role of Physiotherapy: a Report from the Physiotherapy Committee of the International Continence Society
    Received: 11 July 2018 | Accepted: 11 September 2018 DOI: 10.1002/nau.23851 SOUNDING BOARD Obstetric fistula: The role of physiotherapy: A report from the Physiotherapy Committee of the International Continence Society Gill Brook MCSP (DSA)CSP, MSc | The ICS Physiotherapy Committee International Organization of Physical Therapists in Women's Health, Burras Aims: To discuss the role of physiotherapy in the management of women who have Lynd, Otley, West Yorkshire, United suffered an obstetric fistula, referring to research findings when appropriate and Kingdom available, and the experiences of clinical specialists in the field. Correspondence Methods: The experiences of physiotherapists who have worked in countries where Gill Brook, Burras Lynd, Burras Lane, obstetric fistula is prevalent, and the limited literature available, were considered in Otley, West Yorkshire, LS21 3ET, United producing this consensus document on behalf of the ICS Physiotherapy Committee. Kingdom. Email: [email protected] Results: The role of physiotherapy both pre- and post-fistula repair was identified, and is multi-faceted. Women may have general rehabilitation needs based on the obstructed labor itself and subsequent care. All affected women may benefit from pelvic floor muscle assessment, education and exercises to optimize the outcome of their surgery; further pelvic floor physiotherapy may be indicated for those who experience persistent genitourinary dysfunction following closure of the fistula. Conclusions: Further robust research is required to confirm the effectiveness of physiotherapy in the management of women who have suffered an obstetric fistula and the optimum development of such services. Based on the available literature and the experience of physiotherapists in the field, there was consensus within the ICS Physiotherapy Committee that patient outcomes can be improved if physiotherapy is provided as part of the multidisciplinary team.
    [Show full text]
  • Practical Obstetric Fistula Surgery
    Practical Obstetric Fistula Surgery To Dr Catherine Hamlin and the staff of the Addis Ababa Fistula Hospital – especially to Mamitu Gashe, the patient turned surgeon Practical Obstetric Fistula Surgery Brian Hancock MD FRCS Honorary Consultant Surgeon, University Hospital of South Manchester, Manchester, UK Contributing Author Andrew Browning MB BS MRCOG Director, Bahr Dar Fistula Centre, Ethiopia © 2009 Royal Society of Medicine Press Ltd Published by the Royal Society of Medicine Press Ltd 1 Wimpole Street, London W1G 0AE, UK Tel: +44 (0)20 7290 2921 Fax: +44 (0)20 7290 2929 Email: [email protected] Website: www.rsmpress.co.uk Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the UK Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted, in any form or by any means, without the prior permission in writing of the publishers or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the UK address printed on this page. The right of Brian Hancock to be identified as author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act, 1988. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN-13 978-1-85315-766-0 This publication is supported by educational grants from the Hamlin Churchill Childbirth Injuries Fund (UK charity no 257741; www.hamlinfistulauk.org) and the Uganda Childbirth Injuries Fund (UK charity no 10991354).
    [Show full text]
  • Obstetric Fistula Management and Predictors of Successful Closure
    Egziabher et al. BMC Res Notes (2015) 8:774 DOI 10.1186/s13104-015-1771-y BMC Research Notes RESEARCH ARTICLE Open Access Obstetric fistula management and predictors of successful closure among women attending a public tertiary hospital in Rwanda: a retrospective review of records Tekle G. Egziabher, Ngoga Eugene, Karenzi Ben and Kateera Fredrick* Abstract Background: Globally, 50,000–100,000 women develop obstetric fistula annually. At least 33,000 of these women live in Sub-Saharan Africa where limitations in quality obstetric care and fistula corrective repairs are prevalent. Among women with fistula seeking care at public health facilities in resource-limited settings, there is paucity of data on qual- ity of care received. The aim of this study was to characterize obstetric fistula among Rwandan women managed at a public tertiary hospital and evaluate for predictors of successful fistula closures. Methods: A retrospective review of records for all obstetric fistula women managed at a public referral health facility between 2007 and 2013 was performed. Patient socio-demographics, obstetric characteristics and fistula repair out- comes data were reviewed. A multivariate logistic regression model was used to analyse for predictors of successful fistula repair outcomes. Results: A total of 272 women aged between 16 to 78 years and with a mean age of 34.6 years were included. Of these, 93 (34.2 %), 48 (17.6 %), 65 (24 %) and 64 (23 %) women had vesico-vaginal fistula, recto-vaginal fistula, urethro- vaginal fistula and vesico-uteral fistula types, respectively. Successful fistula closure was achieved among 86.3 %. Women with fistula who reported being in labour for 3 days, having 1 previous fistula repair attempt, and having lived with the fistula for >1 year, had significantly lower≥ odds of successful≥ repair outcomes.
    [Show full text]
  • Bi-Salpingo Colonic Fistula Report of Both Fallopian Tubes Fistulizing with Sigmoid Diverticulum with Literature Review
    JKAU: Med. Sci., Vol. 19 No. 3, pp: 103-110 (2012 A.D. / 1433 A.H.) DOI: 10.4197/Med. 19-3.9 Bi-salpingo Colonic Fistula Report of Both Fallopian Tubes Fistulizing with Sigmoid Diverticulum with Literature Review Nawal S. Al Sinani Department of Obstetrics and Gynecology Faculty of Medicine, King Abdulaziz University Jeddah, Saudi Arabia [email protected] Abstract. Fistulous communication between the colon and female adnexal structure rarely occurs. The rarity of the condition reflects that only few cases have been reported in the literature, however, the bisalpingocolonic fistulae have never been reported. A case study of a 28-years-old woman with primary infertility of four years duration diagnosed with bilateral salpingocolonic fistulae by hysterosalpingography (HSG), which was performed as part of the routine work-up of infertility showed; contrast filed both tubes till fimbrial ends then joined diverticulum in sigmoid colon with opacification down to the rectum. Laparoscopic salpingectomy and closure of fistula were done. The patient was referred to the assisted conception unit and underwent two in vitro fertilization. An embryo transfer resulted on the second attempt in pregnancy and a normal healthy full term baby. In conclusions, Salpingocolonic fistula is a very rare disease and closure of the fistula is the treatment of choice with the need to IVF assisted conception. Keywords: Tubo colonic fistula or colosalpingeal fistula, Diverticular disease, Infertility Introduction Fistulous communication between the colon and female adnexal structure rarely occurs. The rarity of the condition is reflected in the fact that only ________________________________ Correspondence & reprint request to: Dr. Nawal S.
    [Show full text]
  • Management of Sexually Transmitted Infections Using Syndromic Management Approach
    MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS USING SYNDROMIC MANAGEMENT APPROACH Guidelines for Service Providers Third Edition V1 March 2007 Ministry of Health - Malawi National AIDS Commission Table of Contents 1. Introduction ...........................................................................................................................................................4 2. Acknowledgements..............................................................................................................................................7 3. The Reproductive Health Policy Statements ..................................................................................................8 3.1. National Reproductive Health Programme............................................................................................8 3.2. Reproductive Health Services Guidelines Principles .......................................................................... 10 3.3. Policies On Cancer Of The Cervix .......................................................................................................... 11 3.4. Policies On HIV/AIDS/STIs ....................................................................................................................... 11 3.5. Policies On Youth ....................................................................................................................................... 12 3.6. Policies On Harmful Practices, Domestic And Sexual Violence ...................................................... 12 3.7. Policy
    [Show full text]
  • Obstetric Fistula Meeting Summary Jul05.Pdf
    MEETING SUMMARY Prevention and Treatment of Obstetric Fistula: Identifying Research Needs and Public Health Priorities The Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health Johns Hopkins School of Medicine, Gynecology & Obstetrics Department United Nations Population Fund (UNFPA) International Federation of Gynecology and Obstetrics (FIGO) World Health Organization (WHO) From 28-29 July 2005, The Bill and Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health hosted a meeting on the prevention and treatment of obstetric fistula. The two-day meeting was co-sponsored by the United Nations Population Fund (UNFPA), the World Health Organization (WHO), and the International Federation of Gynecology and Obstetrics (FIGO). More than 70 clinicians and public health experts from US, Canada, United Kingdom, Benin, Cote d’Ivoire, Eritrea, Ethiopia, Ghana, India, Malawi, Myanmar, Niger, Nigeria, Peru, Romania, and Tanzania participated in the meeting to discuss the extent of obstetric fistula and the best ways to address this public health problem. The meeting continued on July 30 with a subgroup remaining to review the meeting deliberations, define country-specific research priorities and needs, and outline a multi-country research plan. The meeting had several objectives: 1) to advance scientific knowledge on the risk and treatment of obstetric fistula, 2) prioritize research questions regarding public health and clinical responses to obstetric fistula, 3) inform the design of a study addressing one or more key research needs and 4) inform the public health response to and management of obstetric fistula. Problem statement Before the medical advances of the 20th century, fistula was quite common in Europe and the United States.
    [Show full text]
  • The Report on the Prevalence of Pelvic Organ Prolapse, Obstetric Fistula, and Associated Factors in Tigray Region, Northern Ethiopia
    Tigray Region Mums for Mums Mekelle University VSO Bureau Ethiopia The Report on the Prevalence of Pelvic Organ Prolapse, Obstetric Fistula, and Associated Factors in Tigray Region, Northern Ethiopia Tigray Region Bureau of Health, Mums for Mums, Mekelle University College of Health Sciences, and VSO Ethiopia Mums for Mums © 2018 Mekelle, Tigray, Ethiopia June, 2018 1 TABLE OF CONTENTS PREFACE ................................................................................................................................................................ 4 ACKNOWLEDGEMENT ....................................................................................................................................... 5 TECHNICAL WORKING GROUP IN TIGRAY REGION ................................................................................... 6 EXECUTIVE SUMMARY......................................................................................................................................... 7 LIST OF ACRONYMS ............................................................................................................................................ 8 CHAPTER 1: INTRODUCTION ........................................................................................................................... 9 CHAPTER 2: LITERATURE REVIEW ................................................................................................................... 10 CHAPTER 3: THE PROBLEM STATEMENT ......................................................................................................
    [Show full text]