Uganda - Campaign to End Fistula

viEXECUTIVE SUMMARYThe study was sponsored by UNFPA with the overall goal to increase knowledge andunderstanding of the magnitude of the obstetric fistula, among stakeholders, includingexisting capacity and gaps in preventing and treating obstetric fistula in Uganda.“Obstetric fistula occurs as a result of a prolonged and obstructed labour. The pressurecaused by the obstructed labour damages the tissue of the internal passages of thebladder and/ or rectum and with no access to surgical intervention, the woman can beleft permanently incontinent, unable to hold urine or faeces, which leak out through hervagina”.The study was conducted between 19 th February and April 6 th 2003. It was crosssectional, qualitative and quantitative in nature.A total of 114 key informants who included Directors of Health Services and NursingOfficers at the District, Directors and Heads of Hospitals and Departments, Staff from theMinistry of Health Headquarters, relevant authorities of Development Partners and Non-Governmental Organisations, were interviewed. Forty seven service providers (doctorsand nurses) involved in management of VVF currently were also interviewed usingForm 1 to find out their level of skilled training, performance and handicaps in themanagement of VVF.Thirty patients with VVF who were found lying in hospital wards were also interviewedto establish their characteristics, social and economic problems using Form II.Finally, a physical inspection of each National and Regional Referral Hospital wasperformed to establish the adequacy of theatre space, equipment and other suppliesincluding laboratory and X-ray facilities using Form 4 and summarised on Form 5.It was striking to find out that the government had a well laid out policy on themanagement of VVF although it had had poor dissemination or distribution tostakeholders leading to no or hardly any implementation. It is therefore, recommendedthat National Policy Guidelines and service standards for reproductive health be urgentlyprinted and distributed to stakeholders.The magnitude of fistula could not be estimated in this study because of its limited scopeto National and Regional Referral Hospitals, lack of data on VVF and the fact that veryminimal activities were taking place in these hospitals. Because nothing or little iscurrently done for VVF patients they tend to keep away from the hospitals and stay in thecommunities where it is difficult to identify them except on rare occasions of “VVFCamps”.