Uganda - Campaign to End Fistula

3810.0 RECOMMENDATIONS10.1 Immediate Recommendations(ii)(iii)(iv)Mulago National Referral hospital and Mbarara Teaching hospital be immediatelyfacilitated and strengthened with manpower to train VVF management for pre andin-service providers.A core team of four (4) surgeons and four (4) nurses/midwives be trained toconduct VVF camps and in-house training of “medical officers”. Four VVFRegional Management Centres be established, equipped and facilitated atKagando Hospital (West), Arua Hospital (North), Soroti Hospital (East) andKitovu Hospital (Central). The selected sites have functional capacity and acritical mass of clients and would serve as training centres for service providers.Review of medicinal school postgraduate curricula for obstetrics and gynaecologyto introduce fistula management as an examinable subject with measurable ordefined skills and competences.(v) A National Coordinator for VVF programmes be appointed on contract basis for 3years. The coordinator should be a full time job occupied by a Senior ClinicalSpecialist.(vi)(vii)HIMS data collection tools should be upgraded so as to specifically capture dataon VVF/RVF.The National Policy guidelines and service standards for Reproductive Healthservices should be effectively disseminated to all stakeholders, using availablechannels of communication.10.2 Mid-term Recommendations(i)(ii)(iii)(iv)All health sub-district units be equipped and staffed to cater for emergencyobstetric care especially theatre facilities for emergency caesarian section andvacuum extraction.Review of training curricula for Doctors, Nurses and Midwives in labourmonitoring and appropriate interventions, with emphasis on prevention ofobstetric fistula.Advocacy for community participation in health related matters especiallyobstetric fistula.Introduction of referral systems that are reliable and efficient in terms of transportand communication, for all women during pregnancy and childbirth.