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Improving care for women with obstetric fistula: new WHO recommendation on duration of bladder catheterisation after the surgical repair of a simple obstetric urinary fistula.
BJOG. 2018 Nov; 125(12):1502-1503.Under the Sustainable Development Goals (SDGs) and universal health coverage, the "survive, thrive, transform" agenda moves beyond reducing mortality and focuses on the importance of maternal morbidity.((1) ) An obstetric fistula, one of the most devastating types of maternal morbidity, is usually caused by injury during childbirth from prolonged or obstructed labour. The prolonged compression of the fetal head against the pelvic bones can cause ischaemic necrosis of parts of the bladder, urethra or vagina, resulting in an abnormal opening between a woman's genital tract and her urinary tract that leads to the continuous flow of urine through the vagina.((2)) Women with obstetric urinary fistula are often faced with serious social problems including abandonment by their partners, families and communities mainly due to persistent odour of urine as they are constantly wet and unable to control their urinary function.((3)) While these fistulae are almost non-existent in high-income countries, it remains a public health problem that affects over one million women, their families and communities in Sub-Saharan Africa and South Asia with poorly-resourced health systems and inadequate intrapartum care services. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
[New York, New York], United Nations Population Fund [UNFPA], 2008. 35 p.Obstetric fistula, almost unknown in the industrialized world, is most common in poor communities of sub-Saharan Africa and Asia where emergency obstetric care is rarely accessible. It occurs when a woman undergoes a difficult and prolonged labour without prompt medical intervention. Left incontinent, women with fistula are often abandoned by husbands and loved ones and blamed for their condition. Their babies are usually born dead. Like maternal death, obstetric fistula is preventable. Averting it will also contribute to safer childbearing for women throughout the developing world.This publication covers topics such as: 1. Advancing Maternal Health and Rights; 2. Preventing Harm; 3. Healing Wounds; 4. Renewing Hope; 5. Harnessing Momentum.
New York, New York, Family Care International, 2007.  p.This publication explores knowledge, attitudes, and perspectives on pregnancy, delivery, and fistula from 31 country-level needs assessments conducted in 29 countries in the Campaign to End Fistula (see inside back cover for the complete list). Experiences of women living with obstetric fistula, their families, community members, and health care providers are brought to light. This information represents important research on the social, cultural, political, and economic dimensions of obstetric fistula, drawing attention to the factors underlying maternal death and disability. We hope this publication will serve as an advocacy tool to strengthen existing programmes and encourage further research on how to increase access to vital maternal health services, including fistula prevention and treatment. We implore policy makers, programmers, and researchers to listen to these women's voices and consider the promising practices and strategic recommendations described herein. What we have learned so far can help point the way, but much more still needs to be done. We cannot afford to wait-the costs to women, communities, and health systems are simply too great to delay action. Too many of the world's most disadvantaged and vulnerable women have suffered this preventable and treatable condition in silence. Too many women are dying unnecessarily in childbirth. It is time to put an end to the injustice of fistula and maternal death. (author's)