Risk and Resilience: Obstetric Fistula in Tanzania - EngenderHealth

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Annex 2: Details on Women’s Movements, from Initiation of Labor to Final Delivery No. of women Women Not Making Any Moves Delivered at home 1 Delivered at hospital 2 Started labor at home, helped by TBA, delivered at home 4 Women Making One Move Started labor at home, then went to hospital, delivered at hospital 17 Started labor at home with TBA, went to hospital, delivered at hospital 6 Started labor at church/home, went to health center, delivered at health center 2 Started labor in transit to health center, delivered at health center 2 Started labor at home with TBA, delivered in transit to health center 1 Started labor at home, went to TBA, delivered with TBA 1 Started labor at home with TBA #1, went to TBA #2, delivered with TBA #2 1 Women Making Two Moves Started labor at home, went to health center, then went to hospital, delivered at hospital 7 Started labor at home, went to hospital #1, then went to hospital #2, delivered at hospital #2 3 Started labor at home, went to dispensary, then went to hospital, delivered at hospital 3 Started labor at home with TBA, went to dispensary, then went to hospital, delivered at hospital 3 Started labor in the bush, went home, then went to dispensary, delivered at dispensary 1 Started labor at home, went to pharmacy assistant, then went to hospital, delivered at hospital 1 Started labor at home with TBA, went to dispensary, then went to health center, delivered at health center 1 Started labor at home with TBA, went to health center, then went to hospital, delivered at hospital 1 Women Making Three Moves Started labor at home, went to TBA #1, then went to TBA #2, then went to hospital, delivered at 1 hospital Started labor at home with TBA, went to dispensary, then went to health center, then went to hospital, delivered at hospital 1 Started labor at home with TBA, went to dispensary, then went to hospital #1, then went to hospital #2, delivered at hospital #2 1 Started labor at home, went to hospital #1, then went to hospital #2, then went to hospital #3, delivered at hospital #3 1 Women Making More Than Three Moves Started labor at home, went to dispensary, then went home, then went to dispensary, then went home, 1 then went to dispensary, then went home, then went to dispensary, then went to hospital, delivered at hospital 47
Annex 3: Recommendations on the Prevention and Management of Fistula Type of recommendations Frequency of responses Women with Family Community Providers fistula members members Prevention of fistula Deliver in hospital 12 3 3 6 Improve quality of care 2 3 3 4 Attend antenatal care 1 2 2 2 Stay close to health service 1 0 0 Receive information on pregnancy, labor, and delivery 0 0 3 0 Avoid delay 0 1 2 5 Have woman and husband make ANC decision jointly 0 0 0 1 Do not delivery at home/with TBA 0 1 1 3 Save money for transportation and delivery costs 0 0 4 9 Educate community on importance of ANC, maternal 0 4 0 8 complications,pregnancy care, delivery in hospitals, and managing fistula Have community build a hospital 0 1 1 0 Have government provide better quality health care facilities 0 1 0 0 Do not give birth or marry at a young age 0 0 3 0 Have an ambulance available 0 0 0 1 Educate community members to take women in labor to 0 0 0 3 the hospital Do not give birth at a mature age 0 0 0 1 Do not have frequent births 0 0 0 1 Post-fistula Seek treatment for fistula 27 1 0 3 Receive support from family, friends, and community 20 1 1 9 Keep clean 16 1 0 3 Persevere 9 2 1 3 Raise money for living/treatment 7 0 0 1 Have friends and family help with chores/work 1 0 0 0 Do not isolate oneself 0 0 0 2 Look for money for treatment 0 1 0 0 No recommendations 11 0 0 3 Labor and Delivery Receive support from family, friends and community 20 1 1 9 48
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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 44 and 45: VI. Recommendations of Study Partic
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 56: Risk and Resilience: Obstetric Fist
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Risk and Resilience: Obstetric Fistula in Tanzania - EngenderHealth

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