Niger is a landlocked West African nation with one of the hottest climates in the world. Only 15% of its land is suitable for livestock and agriculture. Frequent drought, desertification, and population growth contribute to its economic hardship. Health care services are limited and the country has one of the highest rates of maternal death in the world: One in seven women die in pregnancy or childbirth.
EngenderHealth began its support for fistula services in Niger in 2005 through a grant from the Bill & Melinda Gates Foundation. USAID support began in 2007 via the AWARE-Reproductive Health project followed by the Fistula Care project through 2013. The previous Fistula Care project supported 1,524 fistula repair surgeries and clinical training for 31 doctors and 179 nurses.
The Fistula Care Plus project supports fistula treatment and prevention at five government hospitals:
- Centre National de Référence pour la Fistule Obstétricale (CNRFO), Niamey
- Maradi Regional Hospital, Maradi
- Tahoua Regional Hospital Centre Mère Enfant, Tahoua
- Madarounfa District Hospital, Madarounfa (prevention only)
- Guidan Roumji District Hospital, Maradi (prevention only)
Centre National de Référence pour la Fistule Obstétricale (CNRFO) is located in Niamey, the capital and largest city in Niger. CNRFO serves as the dedicated national referral center for fistula treatment, providing simple and complex repairs to women from across the country. CNRFO is a national and regional training center for surgeons interested in mastering fistula repair.
Centre Mère Enfant de Maradi is housed within the Regional Hospital of Maradi. Maradi is over 600 km east of Niamey, the administrative capital of a region that borders Nigeria’s Sokoto and Katsina states. In spite of ongoing staffing and space constraints, Centre Mère Enfant de Maradi provides emergency obstetric care and family planning services alongside its diverse, routine inpatient and outpatient services. Site staff have been trained on quality service delivery and infection prevention as well as fistula case management.
Centre Mère Enfant de Tahoua is part of the Tassigui Maternity Hospital in Tahoua. Unlike many other regions, Tahoua does not have sub-regional maternity hospitals, which means that the Centre Mère Enfant delivers more than 4,000 babies each year. Fistula Care support to Tahoua began in 2010.
Madarounfa District Hospital is a district hospital in Madarounfa, in the Maradi region. Fistula Care Plus will support quality improvement, communications, and referrals at Madarounfa District Hospital and surrounding health centers in order to facilitate timely fistula treatment and prevention.
Guidan Roumji District Hospital is a district hospital in Guidan Roumji, in the Maradi region. Fistula Care Plus will support quality improvement, communications, and referrals at Guidan Roumji District Hospital and surrounding health centers in order to facilitate timely fistula treatment and prevention.