“After Fistula Repair: Understanding Women’s Needs” – April 10, 2017. The USAID-funded Fistula Care Plus project of EngenderHealth hosted a webinar discussion on understanding women’s needs after fistula repair in Uganda on Monday, April 10, 2017. Genital fistula, whether obstetric, iatrogenic, or from other causes, is a devastating condition with profound health and psychosocial impacts. Surgical repair can restore continence to women who have been living with fistula. However, most fistula programs are unable to follow women after they are discharged from care; consequently, clients’ success in reintegration and their mental and physical health trajectories are not well understood. In order to better understand the long-term outcomes of fistula repair, Makerere University in Uganda and the University of California, San Francisco recently conducted a one year longitudinal study to develop a measure of postsurgical reintegration success and document physical and mental health changes among repaired clients. During the webinar, presenter Alison El Ayadi reviewed the results from this study, while commentators Moustapha Diallo and Rose Mukisa discussed the implications of these findings for the Fistula Care Plus project. Bethany Cole moderated a discussion with questions from webinar attendants.
“Obstetric Fistula and Gender-Based Violence: Examining the Linkages” –Feb 22, 2017. Reproductive outcomes, including maternal morbidities, have a direct impact on a woman’s vulnerability to intimate partner and sexual violence. A new multi-country analysis of data from the Demographic and Health Surveys (DHS) has found that women reporting symptoms of gynecological fistula are also more likely to report experience of physical and sexual violence. These findings raise important questions about the temporal and causal relationships between fistula and gender-based violence (GBV) and about how programs can better serve women throughout their experiences of seeking health services. During the webinar, moderator Lauri Romanzi and presenters Lindsay Mallick and Vandana Tripathi reviewed the literature on fistula and GBV, presented results from the DHS data analysis, and discussed the research and program implications of these findings.
“A Call to Action to End Iatrogenic Fistula”– Aug 17, 2016. Evidence is emerging that iatrogenic causes contribute significantly to the burden of genital fistula in low-income countries. Given the preventability and severity of fistula, data on iatrogenic fistula indicate the urgency of improving surgical training, supervision, and facility capacity, particularly amid increasing rates of cesarean section and gynecologic surgery in low-income countries. While data indicate the need for a consistent definition of iatrogenic fistula, people working on these issues have yet to reach a consensus on definitions or a minimum acceptable standard of surgical care in low-income countries. During the webinar, moderator Bethany Cole and presenters Dr. Lauri Romanzi and Dr. Vandana Tripathi aimed to further the global effort to address these important issues.