Amref Health Africa
Amref Health Africa www.amref.org
Charles Suya(Amref Health Africa Malawi)
Lessons from women identified with fistula in Malawi, a case study of
Mangochi district
Amref Health Africa www.amref.org
Outline
• Background• Coverage• Case Identification Process• Socio – demographic factors• Results• Lessons Learnt• Recommendations• Acknowledgement
Amref Health Africa www.amref.org
• Obstetric fistula is a preventable obstetric complication.
• In Malawi, a high prevalence of obstetric fistula was reported in the Southern region (1.9%).
• Mangochi district, where Amref Health Africa is implementing “Staying alive Project” has higher fistula prevalence of 2.7% (NSO, 2004).
• Population - 948,483 (NSO projections 2013). • Work in 32 facilities• This case study highlights lessons learnt from fistula
identification and management (Mangochi and Blantyre)
Background
Amref Health Africa www.amref.org
Fistula Case Identification-Process
Actors• Health Surveillance Assistants• Fistula repaired clients• Community members• Health Workers Confirmation of cases• Clinicians, specialist surgeons
Amref Health Africa www.amref.org
Socio-Demographic Factors –Identified Cases (n=91)
• Most of the women with fistula (98%) did not complete primary education.
• Average age at which identified women developed fistula was 23.
• The prevalence was higher in women aged between 20 to 34 (54%) than those aged below 19 years. (34% )
• Average period the identified women lived with fistula before access to treatment was 10 years
• 78.3% of these had delivered a maximum of 1 to 4 times• 81% of the women did not have a live baby.• 54 % of the women who were married at delivery were
divorced
Amref Health Africa www.amref.org
Results• First camp was in October 2013 in Blantyre• Currently fistula repairs are done in Mangochi district• 81 women of 91 confirmed cases were successfully
repaired representing a success rate of 89% – 17 (89%) out of 19 - 2013– 21(88%) out of 24, - 2014– 16 (94%) of 17 and – 29 (87%) of 31 were successfully repaired.
The 10 cases that were not successfully repaired will be re-booked for another round of surgery
Amref Health Africa www.amref.org
Lessons learnt• Treating women within the district has assisted to
increase in number of women accessing treatment; they have evidence to take the courage to come out of hiding
• Some women developed fistula under skilled delivery• Psycho social support offers an opportunity to
understand the challenges fistula clients are experiencing
• Use of district based facilities offers an opportunity to repair more women
Amref Health Africa www.amref.org
Recommendations• Intensification IEC to all women even before
they have had the first child. • Strengthen health care systems to to support
reduction of fistula incidence• Establish incidence and magnitude of fistula in
Mangochi. • Strengthen and support Monkey bay to
increase the number of fistula women to repaired within the project span.
Amref Health Africa www.amref.org
Acknowledgements
• Dutch Ministry of Foreign Affairs• Amref Health Africa Flying Doctors• DHMT-Mangochi• UNFPA-Malawi• CHAM• Amref Health Africa Southern Africa Hub• Amref Health Africa Malawi Staying Alive
Team
Thank You for
your attenti
on!Zikomo
.
Top Related