Obstetric fistula has gained much attention in Uganda, thanks to raised consciousness on maternal health and achieve the SDGs especially SDG 3.
Get involved for these three reasons:
- You can raise awareness on the causes of Obstetric Fistula and how to seek treatment
- You can contribute to your communities’ critical number of those who are willing to support women gaining optimal maternal health and achieving the SDGs
- You can make it easier for other members of the community to understand, get involved and participate in prevention of fistula
According to www.prb.org, childbearing poses many risks in Uganda, a largely rural country of 25 million people where the average number of children per woman is almost 7.
Trained medical professionals assist an estimated four in 10 births, and roughly 500 women die of childbirth-related complications for every 100,000 live births, according to the 2000/01 Uganda Demographic and Health Survey (UDHS).
Although some 98 percent of pregnant women receive some level of antenatal care, the survey shows that only 42 percent make the four or more visits recommended by the health ministry. Infant and child deaths are also high. For every 1,000 live births, 88 children die before age 1 and 152 die before age 5.
Most fistula patients in Uganda, like those in other countries, are young and poor with little education and limited access to quality health care, including emergency obstetric care, according to the 2003 Baseline Assessment of Obstetric Fistula in Uganda. Often, patients lack the knowledge that the condition can be repaired and are too ashamed of their condition to seek help. Those who remain untreated may be shunned by their communities and relatives and must find new ways to support themselves.
With little access to healthcare and information about these kinds of risks, young people begin sexual activity and childbearing at an early age. More than half the population (52 percent) is below age 15, and 23 percent of women surveyed at ages 20 to 49 said that by age 15 they were already sexually active, according to the 2000/2001 UDHS. The median age at first sexual intercourse for women ages 20 to 49 was 17 years.
The UDHS also showed that some 31 percent of teenagers had begun childbearing, an improvement over the 43 percent shown in the 1995 UDHS.
Early marriages, linked to social and religious customs among certain tribes, contribute to the high number of teenage pregnancies, since young brides become mothers soon after marriage. Although the minimum legal age for a woman to get married in Uganda is 18, the latest UDHS shows that 17 percent of women ages 20 to 49 at the time of the survey were married by the time they were 15, and more than half were married by age 1.
Most recent studies revealed that in Uganda, there are 1,900 new cases of obstetric fistula per year. There are between 75,000-100,000 who suffer Obstetric Fistula.
From the UDHS (2000/01) statistics that gave 500/1,000 women die in childbirth, there has been been a small reduction to 438/1000 (UDHS 2011).
According to the 2011 Demographic and Health Survey (DHS), 438 women die of birth-related causes for every 100,000 live births in Uganda, and for every woman who dies, six survive with chronic and debilitating ill health (UBOS & ICF International, 2012). Obstetric fistula, a devastating and frequent outcome of prolonged or unattended labor, is an example of this chronic ill health and a significant public health problem in Uganda. Although detailed data about obstetric fistula in Uganda are limited, the 2011 DHS estimated that 2% of Ugandan women aged 15–49 had experienced the condition (UBOS & ICF International, 2012). Obstetric fistula occurs when there has been a gap in maternal health care, preventive services, or community response. Addressing these gaps requires a concentrated and coordinated effort at the national and local levels (WHO, 2006). Surgeons, community leaders, hospital administrators, health care providers, nongovernmental organizations (NGOs), and women needing services are distinct groups with their own needs. Organizing these groups requires leadership, and the Ministry of Health (MOH) is often best placed to provide centralized coordination among the various players to ensure that quality services are available.
Among the women screened and in need of the repair services, for severe rectovaginal fistula (RVF) whose perennial tears resulting into constantly passing feaces or vesicovaginal fistula (VVF). Fistula, is a childbirth injury resulting from unsupervised deliveries especially happening out of hospital.It costs between US$400 (about sh1.4 m) to have a fistula repair done; an amount that an average Ugandan woman cannot afford. The surgery lasts between 1-5 hours depending on the complexity of the case.
According to the UDHS 2011 report on the situation of fistula in Uganda, fistula prevalence stands at 4.0% in the western region.
Globally, UNFPA reports that there are approximately 3.5 million cases of the fistula with up to 100, 000 new cases annually with the majority being in Sub-Saharan Africa and Asia.
In Uganda, UNFPA reports 1,900 new cases of fistula are still occurring every year.
In 2018, UNFPA supported more than 1100 fistula repair surgeries, contributing to 1829 fistula repairs done in Uganda.
Remember you too can get involved.
Get involved for these three reasons:
- You can raise awareness on the causes of Obstetric Fistula and how to seek treatment
- You can contribute to your communities’ critical number of those who are willing to support women gaining optimal maternal health and achieving the SDGs
- You can make it easier for other members of the community to understand, get involved and participate in prevention of fistula
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