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A country of 36 million, Uganda has the second highest fertility rate in the world. Despite progress over the last decade, maternal mortality remains high. Limited access to quality maternal care continues to put Ugandan women at risk of pregnancy-related disability as well. Obstetric fistula, a vaginal injury usually caused from prolonged labor without timely medical attention, is common, and many women are unaware that it can be treated and often repaired.

Since 2004, EngenderHealth has partnered with Ugandan health centers and hospitals to build awareness of obstetric fistula and support its prevention, treatment, and repair. From 2004 to 2013, we trained 26 doctors and 761 nurses to perform fistula repair surgery, and supported a total of 3,534 surgeries. We also greatly improved the quality of obstetric care and family planning services, both of which enable fistula prevention.

Our work today continues to focus on strengthening fistula prevention and treatment in Uganda with the Fistula Care + Project. We are expanding efforts to build community awareness, increasing our emphasis on the integration of family planning services with fistula and maternal health care, and addressing the enormous backlog of women awaiting life-altering fistula repair.

The Expand Family Planning Project (ExpandFP) supports 6 health facilities in two districts of Uganda (3 in Hoima and 3 in Masaka) by building the capacity of service providers who have not been trained in long-acting reversible methods. The project also supports special family planning days at the clinics and mobile outreach services conducted to rural areas in their larger catchment area. The project   works with Village Health Teams, which inform the community about the special event days, in addition to providing information on family planning methods overall. In its second year, the project is working with youth groups, peer educators, and healthcare providers trained in youth-friendly services to ensure greater access to FP services for youth.

During the first year of the project, more than 8,432 family planning clients were served across the two districts, of which approximately 27% voluntarily adopted implants.

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