International Day to End Obstetric Fistula

A. Prevention strategies and interventions to achieve maternal and newborn health and eliminate obstetric fistula. The global Campaign to End Fistula , launched in 2003 by UNFPA and partners, focuses on four key strategies: prevention, treatment, social reintegration and advocacy. The Campaign is active in more than 55 countries and brings together nearly 100 partners with the aim of eradicating fistula globally. UNFPA leads the Campaign and serves as the secretariat of the International Obstetric Fistula Working Group, the main decision-making body of the Campaign. Since 2003, UNFPA has provided direct support for over 129,000 fistula repairs, and partners, such as EngenderHealth, the Fistula Foundation, the Freedom from Fistula Foundation, Direct Relief, the United Nations Federal Credit Union Foundation, Focus Fistula, Women and Health Alliance International and the Kupona Foundation, have provided support for thousands more. UNFPA and the Campaign to End Fistula were awarded the Un...

 RECOMMENDATIONS  Ensure investments to enhance fundamental obstetric services ; strengthen reproductive and maternal and newborn health-care systems with adequate well-trained, skilled medical personnel (i.e. midwives, doctors, surgeons, nurses and anaesthetists), infrastructure and supplies; ensure functioning quality assurance and monitoring mechanisms; and implement strategies to ensure timely access to safe and high-quality surgical repair, including during public health emergencies;    Implement and monitor human rights-based, gender-sensitive and multisectoral national strategies, policies, action plans and budgets to eliminate obstetric fistula by 2030 . Plans and budgets must incorporate the prevention and treatment of fistula and the socioeconomic reintegration and follow-up of fistula patients into programming and budget for achieving the Sustainable Development Goals (including preventing child marriage and adolescent pregnancy and ending gender-based vio...

RECOMMENDATIONS  Increase national budgets for health care and invite the international community to assist with national efforts , upon request, ensuring that adequate funds are allocated to universal access to health care, including strengthening health systems to provide essential maternal health services (high-quality family planning, prenatal, emergency obstetric and postnatal care, and skilled birth attendance) to women and girls, including those living in underserved rural areas where obstetric fistula is most common;  Ensure that national policies and programmes address inequities and reach poor and vulnerable women and girls who are at increased risk , owing to worsened poverty caused by the COVID-19 pandemic, including through the provision of targeted financial relief; the provision of free or adequately subsidized maternal and newborn health-care and fistula treatment under a framework of universal health coverage; and opportunities for community engagement and act...

RECOMMENDATIONS  Ensure holistic social reintegration services for all fistula survivors , including those deemed incurable or inoperable, including health care, counselling, education, socioeconomic empowerment and family and community support;  Develop and strengthen systems and follow-up mechanisms to make fistula a nationally notifiable condition , including indicators to track the well-being and reintegration of fistula survivors, ensuring a human rights-based approach;  Develop strategies to include community engagement to assist women in preventing another fistula after successful repai r, including through education, family planning and caesarean delivery planning;

 RECOMMENDATIONS. Strengthen research, data collection, monitoring and evaluation to guide comprehensive policies, planning and implementation of maternal and newborn health programmes;   Develop, strengthen and integrate within national health information systems routine reviews of maternal and perinatal deaths and near-miss cases , such as obstetric fistula, as part of national maternal and perinatal death surveillance and response systems;    Develop community-based and facility-based mechanisms for the systematic notification of obstetric fistula cases to ministries of health and the recording of those cases in a national register, and acknowledge fistula as a nationally notifiable condition, triggering immediate reporting, tracking and follow-up, using a human rights-based approach;   Provide an enabling environment for social accountability by ensuring access to information on policies, programmes, budgets and specific services to prevent and a...

  RECOMMENDATIONS. Empower fistula survivors to raise awareness and mobilize communities, as advocates for fistula elimination and safe motherhood , and to participate actively in policy formulation, service design and delivery, human rights monitoring and accountability; Strengthen awareness-raising and advocacy , including through the media, schools, health-care facilities and community outreach programmes, with key messages on fistula prevention and treatment and social reintegration; (x) Mobilize communities, including religious and community leaders, women’s groups, civil society organizations, women and girls, men and boys, to advocate for and support universal access to health care, ensuring human rights, reducing stigma and discrimination; Ensure gender equality and the empowerment of women and girls, including through sexual and reproductive health and rights and holistic programming for them, recognizing that the well-being of women and girls has a significant positive e...

Global Campaign to End Fistula. Prevention in Côte d’Ivoire Averting serious childbirth injury can very much depend on who is in the delivery room. The UN has singled midwives out for their crucial role in “saving maternal and newborn lives and preventing morbidity, including obstetric fistula ”. But prevention efforts often occur well before the first pangs of labour. In Côte d’Ivoire, Pastor Kouakou Adou Kouamé – a member of the Ivorian Association for Family Welfare’s fistula support committee – works to spread information about the condition among and beyond his flock at the Bondoukou Baptist Church. “We raise awareness in the communities, the villages,” he said. “It is not only our faithful that we reach.” Pastor Adou uses his position at the pulpit to help people understand and avert the dangers of fistula. Particularly at weddings, he warns newlyweds against home births, which can heighten the risk of childbirth injury. “Soon a child will come,” he tells them. “When a woman is ...