Ethiopia Training Package

Fistula Care partner IntraHealth International developed a training package for midwives, nurses, community health workers, and other health care providers, focusing on the prevention of obstetric fistula by avoiding prolonged or obstructed labor.

In Ethiopia, where an estimated 9,000 women develop a fistula every year (German Foundation for World Population, 2011), the new training package was successfully integrated into 19 health science colleges’ midwifery courses across the country. Hamlin Fistula Hospital is also using the training package for its training of prevention officers.

Development of the skills outlined in this training tool will increase the quality of fistula services while simultaneously targeting community leaders and religious elders to help overcome the societal consequences (such as social stigma) experienced by women living with obstetric fistula. The package is unique in that it does not focus on surgery, like most training programs related to fistula treatment and management. Instead, the prevention information is aimed at teaching providers how to recognize fistula symptoms and where to refer clients and improving their knowledge of pre-repair (preoperative) care.

The training modules incorporate hands-on exercises, visual aids, group discussions, etc., and cover the following topics: safe motherhood and global maternal morbidity and mortality; essential components of antenatal care and emergency obstetric care; prevention of prolonged/obstructed labor (including use of the partograph); identification and diagnosis of obstetric fistula; pre-repair care and referral for women with obstetric fistula; principles of postoperative care, and reintegration of women after obstetric fistula surgical repair; and the roles of families, community, and the health care system in prevention of and care for women with obstetric fistula.