Webinar: Integrating Physical Rehabilitation to Strengthen Fistula and Maternity Care

EngenderHealth’s USAID-funded Fistula Care Plus project, with partners Panzi Foundation and Mama, LLC, hosted a webinar to discuss the impact of integrating physical rehabilitation in fistula and maternity care.

Maternal morbidities such as pelvic organ prolapse and obstetric fistula affect women’s ability to carry out daily tasks and participate fully in society. Surgical treatment is often required to fully repair these conditions. However, for many women, physical therapy (or physiotherapy-informed treatment) can make a profound impact on the severity of symptoms and quality of life. Despite this impact and the low cost of physical therapy relative to many other interventions, these services are often a missing piece in health care, particularly in low-resource settings.

Physiotherapy session with hospital staff at Panzi General Reference Hospital in Bukavu, DRC

During the webinar, Fistula Care Plus and partners Panzi Foundation and Mama, LLC highlighted initiatives to bridge the gap in access to and capacity for pelvic floor physical therapy in low- and middle-income countries and shared examples of progress in this area from the Democratic Republic of Congo (DRC). A new and innovative resource, Implementing Physical Rehabilitation Services into Comprehensive Fistula and Maternity Care: A Training Guide for Health Workers, was presented by Dr. Laura Keyser and Ms. Jessica McKinney, Physiotherapists from Mama, LLC. The training guide is a practical tool for health care workers to introduce physical rehabilitation services into comprehensive fistula and maternity care.

Teaching women about pelvic anatomy and function at Panzi General Reference Hospital in Bukavu, DRC

Case studies were provided on the successful integration of physiotherapy at the Panzi General Reference Hospital in Bukavu, DRC. Dr. Kenny Raha, an OB-GYN and traumatic fistula surgeon, shared his experience providing fistula diagnosis, treatment, and rehabilitation both at the facility and in remote areas of DRC. Dr. Raha believes that fistula surgery is life-changing for women, and physiotherapy can give even better results after recovery. The benefits of physical therapy include decreased length of hospital stay, improved health outcomes, and often reduced need for expensive medical procedures, resulting in improved quality of life.

Success stories were shared by Dr. Rachel Kinja, Physiotherapy department lead at Panzi Hospital. Dr. Kinja stated that “Physiotherapy activities have been implemented among all female staff engaged in the hospital, women engaged in the Panzi Foundation and V-DAY. Women are involved and love to participate in the sessions.” Women from these sessions are then chosen to serve as focal points to form a committee that leads the sub-groups.

At the end of the webinar, Dr. Vandana Tripathi, Fistula Care Plus project Director, reminded attendees that more evidence and standardization are needed so future research can build on frameworks to show the importance of holistic care within fistula maternity care.

Promoting Women’s Well-being through Physical Rehabilitation: The Impact of Integration in Fistula and Maternity Care Presentation  

Implementing Physical Rehabilitation Services into Comprehensive Fistula and Maternity Care: A Training Guide for Health Workers 

Rehabilitation and reintegration programming adjunct to female genital fistula surgery: A systematic scoping review