Pre repair centers for fistula care in Ethiopia

Each year, more than half a million women die in pregnancy and childbirth. Of those that do not perish, an unknown number suffer long-term health problems. One of the most devastating maternal injuries is obstetric fistula, a complication of prolonged and/or obstructed labor. Left with the chronic condition of leaking urine, women with obstetric fistula are often abandoned or neglected by their husbands and families, unable to work, and ostracized by their communities. Ethiopia, was one of the first countries to establish dedicated fistula treatment facilities in 1974—the Addis Ababa Fistula Hospital. In 2006 a partnership between the Ministry of Health, the Addis Ababa Fistula Hospital, the Amhara Regional Health Bureau and three USAID funded organizations (IntraHealth, EngenderHealth and Pathfinder) developed a project to address prevention and care for obstetric fistula. The goals of the program are to educate the community on fistula prevention and care, identify potential clients, screen clients for fistula, provide rehabilitation prior to surgery and provide post surgery support for community reintegration. Unique pre-repair centers screen clients and improve their nutrition and health status before surgery. A qualitative review of the program model, with a focus on the unique pre repair centers was undertaken in November, 2008, involving observation visits to the pre-repair centers, medical record review, interviews with administrators, staff, current and former clients, as well as focus group discussions with community members. Findings from this review and recommendations for expansion of the model will be presented