International Day to End Obstetric Fistula: Experts call for actions to improve maternal health care
Obstetric fistula is a hole in the birth canal caused by prolonged, obstructed labour due to lack of timely and adequate medical care, leaving the woman with devastating injury (a fistula) that renders her incontinent. This condition harms women physically, socially and economically, and often leads to isolation from families and communities, thereby deepening their poverty and worsening their sufferings.
A Gynaecologist and Technical Adviser at Development Communications (DevComs) Network, Dr. Olalekan Olaniyan says early marriage, illiteracy, ignorance and poverty predisposes women to obstetric fistula. According to him, poor health-seeking behavior, delays in using health facility, delays in reaching health facility, poor health infrastructure (for caesarean delivery when needed) make the risk of Obstetric fistula even greater.
The Executive Director, United Nations Population Fund (UNFPA), Dr. Babatunde Oshotimehin, in a release on International women’s day marked recently had said that about 20,000 girls below age 18 give birth in developing countries daily and nine in 10 of these births occur within marriage or union.
Nigeria is one of such countries where child marriage and harmful traditional practices are common, while percentage of birth delivered in a health facility is 35.8% according to Nigeria Demographic and Health Survey (NDHS) preliminary report, 2013. Consequently, over 64% of births take place at home and other places, due to several factors including; inability to afford health services, distance to health facility, concern there may not be a female provider, attitude of health workers amongst others.
According to the World Health Organization (WHO), Obstetric fistula is preventable and can be avoided by delaying the age of first pregnancy; ending harmful traditional practices; and timely access to obstetric care.
Speaking on preventing obstetric fistula, Dr. Olaniyan calls on government to improve health systems and social infrastructure, in order to provide prompt caesarean session for women going through prolonged and obstructed labour. He also advocates for alleviation of poverty, illiteracy and end of harmful traditional practices.
Preventing and managing obstetric fistula contribute to the Millennium Development Goal 5 of improving maternal health, says WHO. The UNFPA recommends universal access to reproductive health services, including maternal health care and fistula treatment. Adding that ‘we must eliminate gender-based social and economic inequities, discourage early childbearing, promote education and human rights, and foster community participation’
Similarly, The United Nation’s Secretary-General, Ban Ki-moon in a statement released for the International Day to End Obstetric Fistula says it is important to raise awareness of the condition because it is not well-understood even in societies where it is prevalent. ‘The more understanding and action we generate today, the more we can look forward to a future where obstetric fistula is virtually unknown’ he said.
Development Communications (DevComs) Network, through its Media Officer, Ayodele Adesanmi, said ending Obstetric Fistula is synonymous to ending prolonged labours, which is the duty of all stakeholders, including government, health workers, community members and the media. ‘The role of the media in reducing stigmatization and violation of the rights of women leaving with fistula cannot be over-emphasized’ he said.
Call to Action
Ending Obstetric Fistula is the responsibility of all stakeholders, however, the government must play a leading role and show will and commitment to improve the quality of maternal health services rendered in the country, through increased budgetary allocations and provision of infrastructures. ‘Obstetric fistula still exists because health care systems fail to provide accessible, quality maternal health care, including family planning, skilled care at birth, basic and comprehensive emergency obstetric care, and affordable treatment of fistula’, says the World Health Organisation.