scholarly journals Building a Country-Wide Fistula Treatment Network in Kenya: Results From the First Six Years (2014-2020)

2021 ◽  
Author(s):  
Lindsey Pollaczek ◽  
Alison M. El Ayadi ◽  
Habiba C. Mohamed
Keyword(s):  
Obstetric Fistula ◽  
Emergency Obstetric Care ◽  
Community Setting ◽  
Community Outreach ◽  
Integrated Approach ◽  
Training Center ◽  
Obstructed Labor ◽  
Treatment Network ◽  
Care Services ◽  
Fistula Treatment

Abstract It is estimated that one million women worldwide live with untreated fistula, a devastating injury primarily caused by prolonged obstructed labor when women do not have access to timely emergency obstetric care. Women with fistula are incontinent of urine and/or feces and often suffer severe social and psychological consequences such as profound stigma and depression. Obstetric fistula affects economically vulnerable women and garners little attention on the global health stage. Exact figures on fistula incidence and prevalence are not known. In Kenya, results from a population-based survey suggest that approximately 120,000 reproductive-aged women have experienced fistula-like symptoms.In 2013, Fistula Foundation designed a program to significantly increase country-wide fistula treatment capacity in Kenya by addressing key barriers that limit women’s ability to receive treatment. Launched as Action on Fistula, and later becoming the Fistula Treatment Network, this model created a network of hospitals, a training center for surgeons and healthcare providers, and robust community outreach and reintegration activities. The Fistula Treatment Network was implemented by Fistula Foundation in collaboration with the Ministry of Health and Kenyan non-governmental and community-based organizations. Fistula Foundation and its donors provided the program’s funding, with seed funding, representing about 30% of the program budget, provided by Astellas Pharma EMEA.Over a six-year period, 2014-2020, the network supported 6,223 surgeries at seven hospitals, established a fistula training center and trained eleven surgeons, trained 424 Community Health Volunteers, conducted extensive outreach to all 47 counties in Kenya, and contributed to the National Strategic Framework to End Female Genital Fistula. At 12 months post fistula repair, 96% of women in a community setting reported that they were dry and not experiencing any incontinence and the proportion of women reporting normal functioning increased from 18% at baseline to 85% at twelve-months. The Fistula Foundation’s Fistula Treatment Network model increased access to fistula care services, strengthened the healthcare workforce, improved understanding of fistula and reduced stigma in a community setting. This integrated approach is an effective and replicable model for building capacity to deliver comprehensive fistula care services in other countries where the burden of fistula is high.

Predictors Of Time To Obstetric Fistula Repair; A Case Study Of Fistula Survivors In Kitovu Mission Hospital (Masaka), Uganda

2019 ◽  
Author(s):  
John Bosco Bomboka ◽  
Jennifer Nakilembe
Keyword(s):  
Public Health ◽  
Obstetric Fistula ◽  
School Level ◽  
Fistula Repair ◽  
Obstructed Labor ◽  
Time To Surgery ◽  
Mission Hospital ◽  
Women And Girls ◽  
Fistula Treatment ◽  
The Cost

Abstract Background: Obstetrical fistula (OF) is a public health challenge that is among the previously neglected components of maternal health in the developing world. The condition, which in the recent past has increasingly drawn more attention from the public, has a devastating impact on the health and wellbeing of both women and girls worldwide. The most common cause of obstetric fistula in developing countries is prolonged obstructed labor affecting approximately 2 million women and girls across Africa and Asia. The objective of this study was to examine the predictors of time to obstetric fistula repair among women who successfully received fistula treatment in Kitovu Mission Hospital. Methods: Hospital records of 149 obstetric fistula survivors from Kitovu Mission Hospital which is located in Masaka district were analysed. Results: Out of 149 participants, 68(45.6%) women were aged 18-24 years and only 28(18.8%) had attained education beyond primary school level. About 72(48.3%) of the survivors received fistula treatment within the first three years of its occurrence. There was a significant relationship among married women (RR = 0.28, p = 0.044), women below 18 years of age (RR = 0.16, p = 0.038), and primiparous mothers (RR = 13.58, p = 0.013) observed at a time to surgery of above 7 years relative to a time to surgery of less than 4 years. Conclusion: In addition to advocacy for a national or community-based health insurance schemes to reduce of the cost for health care, there is need to incorporate campaigns against GBV and increase community sensitization on the importance of ANC among other public health issues on top of fistula.

scholarly journals Obstetric Fistula and Common Peroneal Nerve Palsy in a Rural Based Women: A Case Report

2015 ◽  
Vol 14 (1) ◽  
pp. 71-73
Author(s):  
Suchanda Das ◽  
Rokeya Begum ◽  
Bidhan Roy Chowdhury
Keyword(s):  
Vesicovaginal Fistula ◽  
Obstetric Fistula ◽  
Common Peroneal Nerve ◽  
Home Delivery ◽  
Obstructed Labor ◽  
Labor Ward ◽  
Comprehensive Health ◽  
Common Peroneal Nerve Palsy ◽  
Maternal And Newborn

Neglected obstructed labor is a major cause of both maternal and newborn morbidity and mortality. By far the most severe and distressing long term morbidity following obstructed labor is obstetric fistula i.e. Vesicovaginal fistula. In developing countries fistula is commonly the result of prolonged obstructed labor. A18 year old primi gravida was admitted in the labor ward with the involuntary passage of stool and urine and unable to walk after 15 days of her home delivery. Temporary colostomy was done. Patient was on regular physiotherapy for prolonged time and she was responded slowly. There was a plan for repair of Vesicovaginal and Rectovaginal fistula. Obstructed labor complex is completely preventable if high quality basic and comprehensive health services are available to all. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22891 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 71-73

Integrated Undergraduate, Graduate, and Professional Student (Distance Learning) Education in Thermal Systems Design

2000 ◽  
Author(s):  
Srinivas Garimella
Keyword(s):  
Community Involvement ◽  
Local Community ◽  
Real Life ◽  
Systems Design ◽  
Community Outreach ◽  
Integrated Approach ◽  
Design Studio ◽  
Thermal Systems ◽  
Sustainable Technologies ◽  
K 12

Abstract This paper describes an educational program in practical thermal systems design that encompasses design project-oriented teaching of undergraduate, graduate and off-campus professional students, industry-university collaboration, and community outreach. The program uses an integrated approach that treats thermodynamics, fluid mechanics, and heat transfer as parts of one interconnected area, in which solutions to real-life design problems can be obtained only when all these aspects are considered simultaneously. Cooperation between students at various stages of their educational and professional careers is fostered to maximize the synergy that results from combining insights gained in industry and those developed in structured classroom instruction. The program consists of a comprehensive portfolio of Thermal Systems Design Instruction Initiatives. An interactive design laboratory format is used for cooperative execution of open-ended mini-projects spanning two-to-three weeks, and a semester-long project. The use of virtual project groups through the web removes geographical barriers. Computer programs for the solution of projects are placed on-line to create a design library for use by students in future semesters as case studies. An Energy-Efficient Environmentally-Safe Design Studio is planned where projects on environmental responsibility, and energy efficiency can be conducted for the local community. Annual design studio conferences will be held to foster K-12 and community involvement, and to demonstrate sustainable technologies. Collaboration with local thermal systems related organizations such as the Iowa Energy Center is also being pursued, which will provide inherent mechanisms for technology transfer from course-related projects to industry and the community.

scholarly journals Pregnancy after Obstetric Fistula: Should It Be Encouraged?

2018 ◽  
Vol 13 (3) ◽  
pp. 56-58
Author(s):  
Ranjana Shrestha ◽  
Kenusha Devi Tiwari ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
...  
Keyword(s):  
Obstetric Fistula ◽  
Mode Of Delivery ◽  
Public Health Problem ◽  
Successful Outcome ◽  
Elective Cesarean Section ◽  
Major Public Health Problem ◽  
Fistula Repair ◽  
Obstructed Labor ◽  
Operative Care ◽  
Elective Cesarean

Obstetric fistula (OF) is a life-changing morbidity associated with childbirth. It occurs especially after a prolonged obstructed labor and is a major public health problem in the developing countries. The smell of stool and urine leads to the ostracization and rejection of fistula patients by their spouses, families, friends and society in whole. Surgical treatment of fistula is possible. However, this successful outcome of fistula repair surgery is dependent on pre-operative care and the post-operative care such as delaying the commencement of sexual intercourse and delaying conception. Family planning can aid to this. Pregnancy is advised after minimum of 12 months’ post-repair and mode of delivery should be elective cesarean section. Here, we present a case of 23 years’ female, who suffered from obstetric fistula who underwent obstetric fistula repair twice, re-married and conceived after a year with successful elective cesarean delivery.

Bridging Domains in Efforts to Reduce Disparities in Health and Health Care

2006 ◽  
Vol 33 (4) ◽  
pp. 440-458 ◽  
Author(s):  
Shiriki K. Kumanyika ◽  
Christiaan B. Morssink
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Care Services ◽  
Social Dynamics ◽  
Task Force ◽  
Integrated Approach ◽  
Individual Level ◽  
Advantages And Disadvantages ◽  
Care Services ◽  
The Individual

The concept of health disparities is a familiar one, but we must continually challenge our thinking on how disparities issues are framed. The 1985 Report of the Secretary’s Task Force on Black and Minority Health established a disease-oriented focus on “excess deaths” as the primary targets of disparities initiatives. However, progress in reducing disparities has been limited. The disease focus, which emphasizes the individual-level and health care services, may be too narrow. A “population health” perspective can foster a more comprehensive and integrated approach. Both disease-oriented and population health perspectives have advantages and disadvantages, for both policy and practical purposes. The challenge is to effectively leverage both approaches to improve the health of ethnic minority and other disadvantaged populations. We need bridge builders who can articulate and hear diverse perspectives, work with systems, and maintain a long-term vision for affecting the social dynamics of society

Availability, Utilisation and Quality of Basic and Comprehensive Emergency Obstetric Care Services in Malawi

2008 ◽  
Vol 13 (5) ◽  
pp. 687-694 ◽  
Author(s):  
Eugene J. Kongnyuy ◽  
Jan Hofman ◽  
Grace Mlava ◽  
Chisale Mhango ◽  
Nynke van den Broek
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Services

scholarly journals Barriers to Emergency Obstetric Care Services in Perinatal Deaths in Rural Gambia: A Qualitative In-Depth Interview Study

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Abdou Jammeh ◽  
Johanne Sundby ◽  
Siri Vangen
Keyword(s):  
Perinatal Outcomes ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Transport Cost ◽  
Contributing Factors ◽  
Perinatal Deaths ◽  
Danger Signs ◽  
Care Services ◽  
Transport Services

Objective. The Gambia has one of the world's highest perinatal mortality rates. We explored barriers of timely access to emergency obstetric care services resulting in perinatal deaths and in survivors of severe obstetric complications in rural Gambia. Method. We applied the “three delays” model as a framework for assessing contributing factors to perinatal deaths and obstetric complications. Qualitative in-depth interviews were conducted with 20 survivors of severe obstetric complications at home settings within three to four weeks after hospital discharge. Family members and traditional birth attendants were also interviewed. The interviews were translated into English and transcribed verbatim. We used content analysis to identify barriers of care. Results. Transport/cost-related delays are the major contributors of perinatal deaths in this study. A delay in recognising danger signs of pregnancy/labour or decision to seek care outside the home was the second important contributor of perinatal deaths. Decision to seek care may be timely, but impaired access precluded utilization of EmOC services. Obtaining blood for transfusion was also identified as a deterrent to appropriate care. Conclusion. Delays in accessing EmOC are critical in perinatal deaths. Thus, timely availability of emergency transport services and prompt decision-making are warranted for improved perinatal outcomes in rural Gambia.

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