report of the rapid assessment of vesico-vaginal fistulae in nigeria

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Kees Waaldijk (Baban Ruga Hospital)• Training of Doctors• VVF Repairs in Babbar Ruga Fistula Hospital Katsina, Special VVF CentreBirnin Kebbi, Faridat Yakubu VVF Hospital Gusau, General HospitalHadeija, Lure Fistula Center Kano, Maryam Abacha Hospital Sokoto, KofanGayan Hospital, Zaria.• Training WorkshopsFederal Ministry of Health• Co-financing of Rapid Assessment of VVF situation in Nigeria• Host meetings of the Expert Group on VVFUNFPA• Sponsorship of the Expert Group on VVF meetings• Support for Nigeria’s participation at the International UNFPA meetings onFistulaUNDP• Support for Rehabilitation in Kano StateNAPEP• Provision of Rehabilitation Services for VVF CentresFORWARD (Danbatta VVF Rehabilitation Centre)• Rehabilitation of VVF patientsKano State Government• VVF Repairs at Murtala Mohammed Hospital• Rehabilitation of VVF Patients60
CONSTRAINTS TO OPTIMAL VVF WORK IN NIGERIAA number of constraints have been identified as militating against the prevention ,treatment and rehabilitation of VVF. The following are the main factors identified:• Political CommitmentBefore the NF-VVF and other women organizations embarked on advocacy toraise the level of awareness and political commitment to the cause of VVF,about a decade ago, there was a general ignorance even among policy makersabout the issues relating to VVF. Consequently, the level of politicalcommitment was very low and VVF was never an agenda issue at policy level.Since the onset of advocacy work by NF-VVF the level of politicalcommitment at the federal level has waxed and waned. Of recent however, boththe Presidency and the Federal Ministries of Health and Women’s Affairs andYouth Development have demonstrated commitment to the cause of VVF andhas even initiated the a national project to clear the VVF backlog andrehabilitate the victims. While some state governments have showncommitment and provided resources to support VVF work, others have notbeen forthcoming.• Policy EnvironmentThere is no national VVF policy and most states have no policy on VVF. Otherrelated policies that may be supported of the VVF cause, for example policieson female education, age at marriage for girls, access to comprehensive, qualitymaternal health care including emergency obstetric care, especially in the ruralareas, deployment of nurse/midwives to rural areas, subsidizing the cost ofANC and delivery for women, exemption of VVF patients from payment ofhospital charges, which have all been the focus of NF-VVF advocacy work, arestill on the drawing board/suffering from lack of implementation.61
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REPORT OF THE RAPIDASSESSMENTOFVESI
Page 3 and 4:
LIST OF TABLETable 1States policy &
Page 5 and 6:
CHAPTER 1INTRODUCTIONIn the past de
Page 7 and 8:
AimThe overall aim of the rapid ass
Page 9 and 10: • Officers in-charge of hospitals
Page 11 and 12: causes, cancers and radiation thera
Page 13 and 14: The work of Dr. Ann Ward OFR at St.
Page 15 and 16: 2. Establishment of a VVF hostel an
Page 17 and 18: Other aspects that engaged the atte
Page 19 and 20: Several hospital-based studies repo
Page 21 and 22: In August 1988, Dr. Altine Tongo of
Page 23 and 24: who provided controls. A second con
Page 25 and 26: In this study, it was found that th
Page 27 and 28: other sweet substances, thus preven
Page 29 and 30: on themselves (i.e. possible pathol
Page 31 and 32: OTHER CAUSESLabour and the factors
Page 33 and 34: epair while the patient was trying
Page 35 and 36: likely to have mid-vaginal and high
Page 37 and 38: secondary education and 33% primary
Page 39 and 40: All over the country male children
Page 41 and 42: again before any surgery. The attit
Page 43 and 44: faith it is at times difficult in t
Page 45 and 46: CHAPTER 4RESULTS FROM FIELD ASSESSM
Page 47 and 48: Curative ActivitiesHealth Facilitie
Page 49 and 50: The other crucial need for VVF repa
Page 51 and 52: ackgrounds, this makes their econom
Page 53 and 54: The data on the distribution of hea
Page 55 and 56: VVF Repair OutputAvailable evidence
Page 57 and 58: the details on the payments VVF pat
Page 59: • Rehabiltation• Training of Do
Page 63 and 64: IX. Lack of comsummables for VVF re
Page 65 and 66: The centre has seven doctors, ten n
Page 67 and 68: NASSARAWA STATEWe were not able to
Page 69 and 70: Patients profileThe few VVF patient
Page 71 and 72: InfrastructureThe facility had an o
Page 73 and 74: patients were expected to pay for a
Page 75 and 76: thousand five hundred, surgery thre
Page 77 and 78: Measures to reduce new cases- Econo
Page 79 and 80: state government owned. Federal Med
Page 81 and 82: STATE REPORT NORTH WEST ZONEStates
Page 83 and 84: VVF work started here as far back a
Page 85 and 86: to the patients. He identified the
Page 87 and 88: Patient ProfileMost of the patient
Page 89 and 90: gynaecologist in the hospitals and
Page 91 and 92: patients come to the hospital from
Page 93 and 94: equipment/theatre table trained nur
Page 95 and 96: OGUN STATEAt the Ministry of Health
Page 97 and 98: O & G state specialist Hospital Ado
Page 99 and 100: RECOMMENDATIONSIn the process of th
Page 101 and 102: Table 2: Facilities Involved with V
Page 103 and 104: MedicalCentreQueenElizabethHospital
Page 105 and 106: Table 4 : Doctors and Nurses Availa
Page 107 and 108: UmulogboHoly RosaryHospital Emekuku
Page 109 and 110: staff Working Trained Work VVFrepai
Page 111 and 112:
South East ZoneState Anambra Aghaez
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HospitalAbohMbaiseFederalMedicalCen
Page 115 and 116:
REFERENCES1. Zacharin R.F. Obstetri
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26. Lister U.G. Obstructed Labour-
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Dear Sir or Madam:,We send you gree
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(g) Name of the Hospitals involved
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2. Trained VVF staffName ofYear ofD
Page 125 and 126:
5. How do VVF patients get their Su
Page 127 and 128:
Post operative; Cured, Uncured8. Wh
Page 129 and 130:
APPENDIX 2: LIST OF PERSONS CONTACT
Page 131 and 132:
KebbiKatsinawardVVF, Secretary Dr.
Page 133 and 134:
APPENDIX 4LIST OF DOCTORS AND NURSE
Page 135 and 136:
Dr. Sa’ad IdrisDr. Zubalru Iliyas
Page 137 and 138:
Medical anthropologistDr. Sandra BO
Page 139 and 140:
List of Nurses that receive trainin
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report of the rapid assessment of vesico-vaginal fistulae in nigeria

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