Fistula Prevention and Treatment

Fistula is a hole that develops between the birth canal and one or more of a woman’s internal organs. While it is almost always preventable, fistula is all too common in the developing world, where it is estimated to affect more than 2 million girls and women.

Ganyana Tausi speaks about her work as a youth leader in Mpalo village.Photo: ©Frank Baguma

Consequences of fistula are life-altering: For women with obstetric fistula, the baby usually dies during labor and the mother is left with chronic incontinence, often leading to isolation from family and community life, and neglect or abandonment by male partners. Without surgical repair, a woman’s prospects for work or family support are greatly diminished, and she is often left to rely on charity. These problems are compounded in cases of traumatic fistula, which is caused by rape or sexual violence. In these cases, women face greater psychological trauma and increased vulnerability to HIV or other sexually transmitted infections.

EngenderHealth works to restore dignity to women with fistula and to prevent other women from developing the condition through our Fistula Care Plus project, the largest US government-funded effort to date dedicated to treating and preventing fistula. Our activities include:

Preventing Fistula

• Upgrading emergency obstetric care to prevent obstetric fistula
• Increasing awareness at the community level about fistula prevention and the importance of maternal health care
• Improving access to family planning
• Advocating policy changes that tackle the root causes of obstetric fistula, such as delays in accessing emergency obstetric care
• Promoting gender equity and reducing violence against women

Treating Fistula

• Increasing the number of providers able to surgically repair fistula
• Upgrading medical equipment and supplies at health facilities to ensure high-quality care for women receiving surgical repair for fistula
• Improving providers’ skills in counseling fistula clients
• Supporting women as they re-enter family and community life

For nearly a decade, EngenderHealth has partnered with institutions and surgical teams to facilitate more than 25,000 fistula repair surgeries, transforming the lives of women and their families in 15 countries across Africa and Asia. These surgeries have been possible with support from The US Agency for International Development (USAID) and other generous donors. Currently, we have fistula activities in 10 countries in partnership with other international organizations, local nongovernmental organizations, faith-based organizations, public-sector clinics, and national working groups on safe motherhood.

Publications and Reports:

• Press 1 for Yes, 2 for No: How digital health platforms connect women to maternal health services
• Fistula Care Plus in Uganda: Success Stories
• Bladder Care and Management of Prolonged/Obstructed Labor: A 2017 Global Survey of Intrapartum and Postpartum Clinical Practices
• The Landscape of Cesarean Section in Sub-Saharan Africa and South and Southeast Asia

Films and Videos:

• Learn from My Story
• Bringing Back Dignity
• A Walk to Beautiful
• Fistula Films

Guides and Tools:

• Obstetric Fistula Digital Stories Facilitator’s Guide
• Family Planning for Women and Couples Following Fistula Care
• Educational Tools