Obstetric fistula: ending the health and human rights tragedy.

Osotimehin B
Lancet. 2013 May 18; 381(9879):1702-1703.

More than 2 million girls and women in developing countries are living with obstetric fistula, a condition that has been virtually eliminated in the industrialized world. Obstetric fistula results from prolonged obstructed labor in the absence of emergency medical interventions, notable caesarean section. It is the outcome of the failure of health systems to provide accessible and equitable sexual and reproductive health services, including skilled birth attendance and referral to emergency obstetric care. It further entrenches socioeconomic and gender inequality as many women and girls with fistula are excluded from community life, denied livelihood opportunities, and abandoned by their husbands and families. Major gaps exist in treatment, and while efforts by Direct Relief International, the United Nations Population Fund (UNFPA) and the Fistula Foundation have tried to improve this, the countries with the highest levels of maternal death and fistula have the highest unmet need for sexual and reproductive health services. The article discusses the global efforts to eliminate obstetric fistula, such as the Campaign to End Fistula launched by UNFPA and partners. Through its prevention, treatment, and social reintegration strategies, the campaign is supporting women and girls worldwide to overcome this debilitating and stigmatizing condition. Furthermore, the article emphasizes the power and potential of mobile and e-technologies to empower and transform the lives of the poorest and most vulnerable populations as key to eliminating maternal mortality and morbidity, including obstetric fistula.

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