Risk and Resilience: Obstetric Fistula in Tanzania - EngenderHealth

More documents

Recommendations

Info

VI. Recommendations of Study Participants Study participants offered a number of recommendations on the prevention and management of fistula. A. Recommendations Regarding Prevention of Fistula Hospital-Based Attendance and Support at the Time of Delivery Delivering at a hospital was the most often cited recommendation to prevent fistula given by girls and women themselves. This recommendation was frequently echoed by family, community members, and health care providers. Women and health care workers also strongly recommended that family, friends, and community members provide support during delivery. delivery. As one patient from Bugando stated, “At our dispensary, there are no nurses to examine us, there is no treatment for pregnant mothers, and no medicine. We have to buy the medicine. Unfortunately, I have lost the baby because of lack of health services.” (Patient at Bugando, age 24) Tanzania faces an acute shortage of health care workers. In addition, people often cite the scarcity of drugs and medicines at health care facilities as serious problems. While Tanzania has a relatively good distribution of primary health care facilities, the quality of care provided within those structures needs significant improvement to reduce maternal deaths and other conditions impacting the poor. As one woman explained, “It is important to go to deliver at the hospital, because if it happens that you get the problem, you will be assisted.” (Patient at Bugando, age 25) A woman from Songea reported that she would not have had this problem (fistula) had she given birth at the hospital. Even with intentions to assist women to deliver in hospitals, people face obstacles in accessing such care. As the husband of a woman with fistula described, he had wanted his wife to stay at a hospital until she delivered, but he had no money for the hospital costs, and no one at home to care for the family. The combination of these two impoverishing factors created a barrier to accessing hospital care at the time of delivery. Saving Money for Transport and Delivery Community members and health care providers mentioned the need to save money for transportation and delivery costs. These two challenges are confirmed by findings of the 2004–2005 DHS, which found that money and transport are the leading barriers for women seeking health care (NBS & ORC Macro, 2005). Quality of Care All four groups of study participants recommended improving the quality of services during labor and Community Education and Avoidance of Delays Family, and particularly health care providers, recommended educating the community on the importance of antenatal care, maternal complications, pregnancy care, and delivery in hospitals. Health care providers in particular recommended that people avoid delays in referring girls and women for care during labor and delivery . Summary The figure overleaf presents the recommendations given by different groups of respondents regarding prevention of fistula. More details about the responses are provided in Annex 3. 37
Figure 6: Recommendations on the Prevention of Fistula B. Recommendations on Management of Fistula Number of responses 30 25 20 15 10 5 0 Deliver in hospital Improve quality of care Providers Attend antenatal care Community Members Avoid delay Save for expenses Friends & Family Educate community Women with Fistula Seek Treatment and Provide Support Seeking treatment and the provision of support from family members and others were the most often cited recommendations by girls and women. The support of people for girls and women living with fistula was also recommended by health care providers. Other Recommendations The women and girls also strongly recommended to keep clean, “persevere,” and try to generate income for daily living and the costs of treatment. Summary The figure below presents the recommendations given by different groups of respondents regarding post-fistula care. More details about the responses are provided in Annex 3. Figure 7: Recommendations on Post-fistula Care 35 30 25 Number of responses 20 15 10 5 0 Seek treatment Support from others Keep clean Persevere Raise money Providers Community Members Friends & Family Women with Fistula 38
Page 2 and 3: RISK AND RESILIENCE: Obstetric Fist
Page 4 and 5: Table of Contents Acronyms v Acknow
Page 6 and 7: Acronyms and Abbreviations ANC CCBR
Page 8 and 9: Executive Summary Fistula provides
Page 10 and 11: eported delay was “delay in trans
Page 12 and 13: II. Study Design and Methodology A.
Page 14 and 15: D. Study Participants Study partici
Page 16 and 17: F. Data Collection Data collection
Page 18 and 19: IV. Study Limitations A. Length of
Page 20 and 21: Moreover, the services received var
Page 22 and 23: one woman indicated, “I and my fa
Page 24 and 25: After family and friends, the most
Page 26 and 27: TBAs referred the women to a health
Page 28 and 29: The length of labor reported by wom
Page 30 and 31: fistula, and when his other daughte
Page 32 and 33: Table 10: Providers’ Knowledge ab
Page 34 and 35: need to clean themselves and change
Page 36 and 37: I. Impact on Family “It is hard o
Page 38 and 39: One woman was accused of having gon
Page 40 and 41: Figure 4: Type of Support Given Num
Page 42 and 43: One woman expressed her desire to r
Page 46 and 47: VII. Findings and Recommendations F
Page 48 and 49: If providers are able to conduct AN
Page 50 and 51: findings are in sharp contrast to r
Page 52 and 53: References Kayongo, M., et al. 2006
Page 54 and 55: Annex 2: Details on Women’s Movem
Page 56: Risk and Resilience: Obstetric Fist

Risk and Resilience: Obstetric Fistula in Tanzania - EngenderHealth

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?