Uganda - Campaign to End Fistula

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40(xi)(xii)Detailed protocol and guidelines on management of obstructed labour andrepaired fistulae should be developed, including communication skills for thehealth staff and distributed to all health facilities.Center(s) of Excellency in VVF CareGovernment and development partners should consider center(s) to serve womenwith VVF. This can act as a nucleus from which outreach teams can travel allover the country to offer services and support to less privileged individuals in therural areas.10.3 Long-term Recommendations(ii)(ii)(iii)(iv)(v)(vi)(vii)There is need to train health professionals involved in the management ofobstetric fistula using locally adapted guidelines and standards.The following interventions should be strengthened to ensure access of services.• The provision of transport for referral,• Adequate staffing,• Financial logistics,• Supplies and appropriate equipment.All regional referral hospitals should be equipped with VVF specialisedequipment. Efforts be made to introduce regional training and service centres toimpart improved skills in the treatment of obstetric fistula – hands on in-servicetraining.Every effort should be made to put in place programmes or activities that offersupport and rehabilitation to women with fistulae within their communitieswithout enhancing stigmatization.Communities and rural health workers should be sensitized on the cause andprevention of obstetric fistula, so that women who sustain obstetric fistula aremobilised and motivated to go for surgery.The government should encourage Education of the “girl child” and “economicempowerment of women and their communities”.High profile should be given to the cause and prevention of obstetric fistula andthis could increase the number of women coming for delivery in health units.(viii) Prevention of formation of new fistula by implementing the safe motherhoodobjectives:• Provide guidance to health care providers in the delivery of quality maternaland newborn care services at all levels.
41• Enhance quality of safe motherhood services- Pre-conception care e.g. Nutrition and adolescent health;- Antenatal care- Intrapartum care- Emergency obstetric care- Postnatal care• Provision of adequate accurate information education and counselling servicese.g.Adolescent Sexual Reproductive Health• Integrated maternal and newborn service into National health System.(ix)Review clinical procedures that create barriers or delay in management of fistulapatients• Timing of pre-operative assessment under general anaesthesia• The role of post operative chemoprophylaxis• Routine pre-operative laboratory investigations
Page 2 and 3: REPORT OF THE BASELINE ASSESSMENT O
Page 5 and 6: 9.9 Attitudes of Health Care Provid
Page 7 and 8: vACKNOWLEDGEMENTFirst and foremost
Page 9 and 10: viiThese were major constraints ide
Page 13 and 14: 3High levels of childhood malnutrit
Page 15 and 16: 52.0 TERMS OF REFERENCE2.1 Objectiv
Page 17 and 18: 74.0 RESULTS4.1 PolicyIn the year 2
Page 19 and 20: 9hence would never qualify for subs
Page 21 and 22: 11VVF week was carried out between
Page 23 and 24: 135.9 Hoima Referral HospitalThis h
Page 25 and 26: 155.14 Kuluva HospitalThis is Churc
Page 27 and 28: 175. 21 AMREF Flying in Doctors: Dr
Page 29: 19The training curriculum never spe
Page 32 and 33: 226.18 Geographical and Ethnical Di
Page 34 and 35: Typical Road up the hills off Kabal
Page 36 and 37: 267.0 CHARACTERISTICS OF PATIENTS W
Page 38 and 39: 287.11 Condition of the baby at Del
Page 40 and 41: 30Provision of quality care may con
Page 42 and 43: 32supplies. The problem is compound
Page 44 and 45: 34Bicycle Ambulance (hind view)Brok
Page 46 and 47: 369.10 Characteristics of Patients
Page 48 and 49: 3810.0 RECOMMENDATIONS10.1 Immediat
Page 52 and 53: 4211.0 HOSPITAL SUMMARY FORMForm 4N
Page 54 and 55: 44Name of HealthUnitMULAGOHOSPITALC
Page 56 and 57: 46LIST OF INSTRUMENTSList of Instru
Page 58 and 59: 48Basic Laboratory RequirementSn It
Page 60 and 61: 50Supplies and Equipment (* Optiona
Page 62 and 63: 5253 Sphygmomanometer 154 Stethosco
Page 64 and 65: 37. Dr. Osinde Obstetrician/Gynaeco
Page 66 and 67: 56OBSTETRIC FISTULA (VVF)PROVIDER/F
Page 68 and 69: 58e. Clamps……………………
Page 70 and 71: 60OBSTETRIC FISTULA (V.V.F)PATIENT
Page 72 and 73: 62OBSTETRIC FISTULA (V.V.F)Form 3KE
Page 74 and 75: 641. What is the policy?MINISTRY OF
Page 76 and 77: 668. X-ray (IVP)9. Cytoscopy10. Exa
Page 78: 6817. Raassen Tom: VVF Surgery Repo

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