france donnay unfpa representative pakistan
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Toward Women’s Health and Rights Campaign to End Fistula. France Donnay UNFPA Representative Pakistan. 8 March 2007. Obstetric fistula. Fistula is caused by prolonged, obstructed labor. - PowerPoint PPT PresentationTRANSCRIPT
France DonnayUNFPA Representative Pakistan
8 March 2007
Toward Women’s Health and RightsCampaign to End Fistula
Obstetric fistula
Fistula is caused by prolonged, obstructed labor. The pressure of the baby’s head against the mother’s pelvis causes extensive tissue damage, leaving a hole between her vagina and bladder or rectum, making her incontinent. The baby usually dies.
Obstetric FistulaObstetric Fistula
Here is a Bangladeshi woman with a picture of her baby boy. Her husband left her. She is waiting for the operation. How hopeful she looks…
Living With Fistula
Primarily affects young, poor women with little or no access to services
Medical consequences: incontinence, infection, infertility
Social consequences: isolation, abandonment, stigma, vulnerability
How common is fistula?
Incidence: Global: 50,000 to 100,000 new fistula cases each year (WHO) Kenya:1 to 2 fistula cases per 1,000 deliveries East Africa: 3 to 5 cases per 1,000 deliveries in areas with no
access to EmOC Prevalence: 2 million worldwide (WHO) Kenya – 30,000 Bangladesh – 70,000 Nigeria – between 400,000 and 800,000
The Campaign to End The Campaign to End FistulaFistula
The Campaign to End Fistula aims to make fistula as rare in Africa and Asia as it is in the industrialized world. The Campaign involves a wide range of partners and supports close to 30 countries.
UNFPA Strategy: Provide a continuum of care from prevention to treatment
to social reintegration into families and communities
Before the CampaignBefore the Campaign
Limited information available on obstetric fistula Fistula not acknowledged by government
policies or health systems Women encounter many barriers to accessing
quality obstetric services to prevent fistula Treatment services unavailable or inadequate Almost no provision of social support services
for fistula survivors
National Level Planning & Advocacy
Raise awareness among national stakeholdersForm intersectoral coalitions and partnershipsBuild capacity through training and equipment provision
Needs assessments provide crucial dataDevelop national strategies and plans of action in connection with safe motherhood
Strategic Interventions: Prevention
•Helping couples plan & space their births•Skilled attendant at each birth•Available and accessible emergency obstetric care •Educating and engaging men and women about the need for maternal health care
Strategic Interventions: Treatment
•Quality surgical and post-operative care•Training health professionals and strengthening hospitals•Make sure it is free of charge (most too poor to pay)
Strategic Interventions: Social Reintegration
•Counselling•Health Education including follow-up care and the next pregnancy•Skills training, small grants
Global and Regional Advocacy
Extensive media coverage Published journal articles Presented at numerous global/regional technical
fora 4 international/regional fistula meetings Campaign Website, brochure, logo Celebrity spokesperson: Natalie Imbruglia Innovative PR campaigns with private sector Fistula as a compelling issue to mobilise a diverse
funding base
Lessons Learned from Country Implementation
Comprehensive approach is needed, including prevention, treatment and social reintegration, in the safe motherhood context - emphasis on prevention
Needs assessments important first phase for both planning and advocacy
Treatment services should be available before public awareness activities are undertaken
Support services should include psychosocial, social and economic components
Diverse, multi-sectoral partnerships at all levels ensure a comprehensive and coordinated response
MDG Task Force Recommendations
SRH – including family planning - essential for both maternal and child health goals
Strengthening health systems is key, from community practices up to first level referral facilities
Professional attendance (w/h attention to overmedicalization) and EMOC when complications
Focus on equitable access by removing financial and cultural barriers
Address HR issues including brain drain, devolution, rights and working conditions of health workers
Build capacity of information systems
UNFPA: our response
Family planning : prevent unwanted pregnancy and unsafe abortion
Skilled care at childbirth : a skilled attendant in an enabling environment
Emergency Obstetric Care to manage complications
Essential Neonatal Care Maternal nutrition Access for the poor Maternal morbidity : Obstetric Fistula
Campaign ProgressCampaign Progress Bangladesh
Providing treatmentTraining health personnelImproving data collection
and monitoring systems Niger
Broad partnership established
Training for community health agents
Providing innovative support services
Fistula is a lens onto Fistula is a lens onto many issuesmany issues
Fistula highlights:Reproductive rightsRH and Safe
MotherhoodAdolescence and Early
Marriage/ChildbearingPoverty
Campaign Campaign SupportersSupporters Governments: Australia, Austria, Canada,
Finland, Luxembourg, New Zealand, Switzerland
Gates Foundation United Nations Foundation Human Security Fund Regional Development Banks "34 Million Friends" Campaign Innovative partnerships under development
with the private sector
Fistula as Catalyst?
Accelerating contribution to MMR and RH programs 5 ingredients :
– political commitment– female education– strengthening of health systems– supportive family and community practices– roads and telecommunications
Political movement taking advantage of MDG momentum
Why focus on fistula?
Many women are affected
Fistula is Preventable and Treatable
Strategy for reaching the poorest women
Fistula puts a face to reproductive health issues