Technical Briefs

Is It Feasible to Implement a Cesarean Indication Classification System? Findings from Five Countries (English, PDF, 3952 KB) EngenderHealth, September 2016 The Fistula Care Project at EngenderHealth, predecessor to the current Fistula Care Plus Project, conducted a study in 2009 and 2010 to assess the feasibility of using an indications-based cesarean section classification system. This brief describes key findings of the study and implications for tracking cesarean section trends.

Iatrogenic Fistula: An Urgent Quality of Care Challenge (English, PDF, 5 MB) EngenderHealth, August 2016
Evidence is emerging that maternal morbidity is related to quality of care challenges: Iatrogenic causes appear to contribute significantly to the burden of genital fistula in low-income countries.The Fistula Care Plus (FC+) project has sought to raise awareness about this important issue, documenting current trends and perceptions related to iatrogenic fistula and identifying actions that partners can take to address the problem. 

Improving Partograph Use in Uganda through Coaching and Mentoring (English, PDF, 1.82 MB; French, PDF, 1.4 MB) EngenderHealth, August 2013
Since 2010, Fistula Care has collaborated with the Reproductive Health Department of the Ugandan Ministry of Health to strengthen partograph use. This technical brief describes the challenges and achievements of developing and implementing a new approach to support partograph use in five facilities across three districts and makes recommendations for future partograph programming at the national, district, and facility levels.

Creating an Enabling Environment for Fistula Prevention and Treatment in Uganda (English, PDF, 14 KB; French, PDF, 2.1 MB) EngenderHealth, March 2013
The Fistula Technical Working Group was established by the Ugandan Ministry of Health’s Clinical Services Department to ensure equitable access to health care for women with fistula, promote prevention strategies, maximize the efficient use of resources, eliminate duplication of effort, and foster a community of providers. This brief describes three important achievements of the Uganda Ministry of Health and the Fistula Technical Working Group: building an information base for obstetric fistula to better plan for and manage prevention, treatment, and reintegration services; integrating fistula services into the Uganda health system; and establishing standards, guidelines, and protocols to guide services.

Living with Obstetric Fistula: Qualitative Research Findings from Bangladesh and the Democratic Republic of the Congo (English, PDF, 1 MB; French, PDF, 750 KB) EngenderHealth, August 2012
What are the social consequences of fistula? What affects how women with fistula are treated? Fistula Care is pleased to announce its latest technical brief, which provides insights into the experiences of women with fistula in Bangladesh and the Democratic Republic of the Congo. This qualitative research examines the lives of women suffering from fistula in two very different sociocultural contexts, including the physical and social consequences associated with the condition and women’s attempts to obtain care.

Community-Based Screening for Obstetric Fistula in Ebonyi State, Nigeria  (English, PDF, 981 KB; French, PDF, 1.25 MB) EngenderHealth, March 2012
In 2007, the Mother and Child Care Initiative (MCCI) was launched in Ebonyi State, under the leadership and support of the governor’s wife, the Honorable Mrs. Josephine Elechi. In 2008, prior to the construction of a new obstetric fistula center in the state, MCCI coordinated with local governments to deploy a specialized medical team to conduct community-based screening for obstetric fistula throughout Ebonyi State, in order to estimate the potential backlog of women needing fistula repair surgery. This technical brief describes the planning process for the community screening and the results of this effort.

Low-Cost Ambulance Network to Improve Access to Maternity Services in Dhaka, Bangladesh (English, PDF, 736 KB; French, PDF, 781 KB)
EngenderHealth, March 2012
Transportation to skilled maternity care is critical. In 2008, the Ad-din Hospital recognized that many women in Dhaka were unable to access emergency obstetric care and established a low-cost ambulance service. This technical brief describes how Ad-din uses mobile phones and global positioning system (GPS) tracking to manage a fleet of 66 ambulances stationed throughout the city.

Increasing Access to Maternity Services in Rural Bangladesh: Sustainable Facility-Community Links (English, PDF, 1.1 MB; French, PDF, 1.2 MB)
EngenderHealth, March 2012
The Ad-din Hospital for Women and Children and the LAMB Project in Bangladesh have established community-level services for women in rural, underserved communities. This technical brief describes their noteworthy programs, which ensure community ownership and sustainability. One program is integrated into a microfinance program to enable financial independence; the other empowers community members to truly own and manage its services.

Integrating Fistula Treatment and Prevention: The Launch of a Maternity Unit in Sierra Leone (English, PDF, 2.3 MB; French, PDF, 1.6 MB)
EngenderHealth, January 2012
The Aberdeen Women’s Centre maternity unit began offering delivery services in May 2010. Today, its dedicated staff provide hundreds with women high-quality maternity services each year. This brief details the challenges of opening a maternity centre, and the factors that have led to the success of the clinic today.

Making Mobile Phones Work for Women with Fistula: The M-PESA Experience in Kenya and Tanzania (English, PDF, 2.2 MB; French, PDF, 666 KB)
EngenderHealth, March 2011
This brief discusses the work of the Freedom from Fistula Foundation in Kenya and Comprehensive Community Based Rehabilitation in Tanzania. Both programs use an innovative combination of mobile banking and community education to provide free fistula treatment to women who need it.

Beyond Repair: Involving Communities in Fistula Prevention and Reintegration–Experience from Kissidougou, Guinea (English, PDF, 1.96 MB; French, PDF, 3.3 MB) EngenderHealth, September 2010
This brief discusses engaging local government and community members in treatment, reintegration and prevention of fistula.

A Collaborative Network to Improve Access to Fistula Treatment in Nigeria (English, PDF, 3.38 MB; French, PDF 600 KB) EngenderHealth, August 2010
This brief describes the pooled effort strategy that the Nigeria team has been leading to expand access to fistula repair services.

Fistula Pre-Repair Center Model in the Amhara Region of Ethiopia (English, PDF, 467 KB; French, PDF 639 KB) EngenderHealth, November 2009
This brief provides readers with an overview of USAID support to three pre-repair centers in the Amhara Region which are part of a partnership with the Amahara Regional Health Bureau and the Bahir Dar Hamlin Fistula Hospital.