Resources for Fistula Services

Surgical Safety Toolkit

Toolkit Orientation Video, produced in collaboration with Medical Aid Films

Informed Consent in Fistula Care (English, PDF, 630 KB; French, PDF, 617 KB)                                                             Informed consent is a critical component of quality fistula care services. This booklet for service administrators, clinical staff and supervisors provides guidance on counseling patients before fistula surgery and a sample consent form. Clients may find the provided information helpful in making an informed decision on care.

Client Tracker Form and Database (English, PDF, 899 KB; English, Excel 115 KB; French, PDF, 1,057 KB; French, Excel, 117 KB)
The client tracker is a tool for clinicians to collect information on patient care related to fistula, POP, incontinence and other genital tract conditions. The tool is organized into eleven sections: quality assurance required data, obstetrics and gynecology profile, pertinent history, staging and diagnosis, admission, non-surgical procedures and outcomes, surgical procedures and outcomes, complications and sentinel events, discharge, safety checklists completed, and family planning counseling sessions. The PDF version is to be used as a form to be filled out as a hard copy. The Excel version is a database that allows clinicians to record the data they collected from the client tracker forms into a client database. Clinicians and researchers can conduct analysis on patient data for fistula, POP, incontinence and associated genital tract conditions using a populated database.

Sentinel Events (English, Word, 476 KB; French, Word, 457 KB)
The sentinel events document includes instructions on how FC+ supported service facilities should report deaths/mortalities and morbidities related to fistula, POP, incontinence and other genital tract conditions. The document also provides a worksheet for clinicians and facilities to calculate the number of morbidities for the month, as well as forms to report both mortalities and morbidities facility supervisors and to FC+ senior managers.

Surgical Safety Checklists (English, Word, 358 KB; English, PDF, 993 KB; French, Word, 280 KB; French, PDF, 1,063 KB)
This document provides clinicians with safety checklists to reference throughout the stages of care for patients dealing with fistula, POP, incontinence or other genital tract conditions. The seven safety checklists include: surgical candidacy, pre-op clearance, WHO surgical safety, Operation report,; Patient transport, and Discharge summary. Each of the checklists, except the WHO surgical safety checklist, has an accompanying adaptable, template medical record form that clinicians may find useful to include in the documentation of their patients progress throughout their care.

Trainee Skills Tracker (English, PDF, 626 KB; English, Excel, 287 KB; French, PDF, 655 KB; French, Excel, 288 KB)
Surgical trainees can use the trainee skills tracker to monitor their progress in sequential training sessions for fistula, POP, incontinence and other genital tract issues. The document contains four skill-based modules: outpatient evaluation & non-surgical management; fistula repair; POP & incontinence treatment, and cross-cutting intra-operative decision making, surgical finesse and healthcare team leadership skills. The PDF version can printed and completed by hand for a single training session; whereas the excel version allows trainees to track their progress across multiple training sessions within each module.

Provider Job Aids

Informed Consent in Fistula Care (English, PDF, 630 KB; French, PDF, 617 KB)
Informed consent is a critical component of quality fistula care services. This booklet for service administrators, staff and supervisors provides guidance on counseling patients before fistula surgery. Clients may find the provided information helpful in making an informed decision on care.

Informed Consent Form (English, PDF, 35 KB; French, PDF; 36 KB)
This form is a template for service providers that can be used or adapted for providers to counsel fistula patients before surgery.

Client-Centered Reproductive Health Counseling Following Fistula Repair (English, PDF, 164 KB; French, PDF, 169 KB; Bangla, PDF, 203 KB)
This poster provides service providers with basic guidance on counseling women and couples following fistula surgery.

Quick Reference Chart for Contraceptive Methods (English, PDF, 162 KB; French, PDF, 167 KB; Bangla, PDF, 372 KB)
This poster lists basic information about family planning methods for service provider’s reference.

Fistula Diagnosis Job Aid (English, PDF, 261 KB; French, PDF, 232 KB; Bangla, PDF, 225 KB)
This brochure assists health care providers to diagnose obstetric fistula in women who present with urine leakage. It contains a list of questions aimed to accurately diagnose whether the woman has obstetric fistula, whether she requires surgical repair, and the complexity of the repair. It also provides advice for preparing for obstetric fistula repairs.

Fistula Diagnosis Poster (English, PDF, 767 KB; French, PDF, 831 KB )
This poster presents the diagnosis job aid in a chart format.

Prevention Poster for Providers (English, PDF, 737 KB)

Digital Stories Facilitator’s Guide (English, PDF, 2.89 MB; French, PDF, 2.76 MB)
This guide serves as a companion to the “Learn From My Story” series. In order to help people to listen to and use the stories, a facilitator’s guide was created and includes: the text of each woman’s story, discussion questions tailored to each woman’s story, and key messages for facilitators to convey. The intended use of the guide is with three main audiences: health care providers, women with fistula, and community members.

Service Delivery

Counseling the Obstetric Fistula Client: A Training Curriculum (English, PDF, 2.5 MB; French, PDF, 2.8 MB)
Counseling is an integral part of comprehensive fistula care services. The curriculum guides nurses, midwives, and physicians to help their clients to make informed and voluntary decisions about their care. The curriculum addresses counseling needs related to fistula prevention, treatment, and social reintegration. Health care providers can also find information about how to engage with the client’s family and how to link the client to supportive organizations in the community.

Counseling the Traumatic Fistula Client: A Supplement to the Obstetric Fistula Counseling Curriculum (English, PDF, 3.4 MB, French, PDF, 3.2 MB)
Clients seeking care for traumatic fistula–fistula caused by sexual assault–need access to counseling that addresses the complex effects of their condition. This supplement complements the counseling curriculum to address the physical, social, and psychological impacts specific to traumatic fistula. The supplement also provides information on how health care providers working with traumatic fistula clients can seek support for themselves.

Data for Decision Making in Fistula Treatment Services: A Supplemental Module for Facilitative Supervision (English, PDF, 2.8 MB; French, PDF, 2.6 MB)
In keeping with its commitment to quality improvement, Fistula Care promotes the use of data for decision making. This series of training modules provides clinical supervisors, health care providers, and national-level stakeholders with skills to review and interpret data in order to strengthen health systems and services. The document includes guides for discussion and interactive activities, as well as handouts and other tools to teach lessons about data gathering, analysis, and application. The modules supplement EngenderHealth’s facilitative supervision tools, which emphasize team problem-solving and communication.

Service Delivery Supervision and Monitoring Checklist (English, PDF, 114 KB; French, PDF, 145 KB)
This checklist facilitates the supervision and monitoring of fistula repair service delivery. Forms include: Facility Information; Fistula Service Delivery at Facility; Monitoring of Counseling Services; Notes from Client Interviews; and Summary Notes and Recommendations from the Supervision and Monitoring Visit.

Recommendations for Equipment and Supplies (English, PDF, 41 KB)

Site Assessment

Site Assessment Tool (English, PDF, 456 KB; French, PDF, 925 KB)
This is a set of 284 questions to assess the availability and quality of services for fistula prevention and treatment sites. It also includes a list of standard fistula facility equipment and supplies.

Site Assessment Preparation and Report Guidelines (English, PDF, 296 KB; French, PDF, 777 KB)
This package of materials provides instruction for how to carry out a site assessment. Forms include: Proposal guidelines; Tip Sheet for Planning the Assessment; Site Assessment Tool; and Presentation of Findings: An Outline for the Assessment Report.

Site Surveys

FC+ Supported Facility Survey 2015: Fistula backlog and prolapse integration (English, PDF, 883 KB)                                 This survey collected information from health facilities that conduct surgical fistula repairs with support from the FC+ project. The survey asks questions about fistula backlog and current demand and capacity for pelvic organ prolapse (POP) services.