Stakeholders collaborate to improve Vesico Vaginal Fistula care

Stakeholders are mapping out strategies to improve fistula care to enable Nigeria to meet the 2030 global target to end the syndrome.

The stakeholders began a two-day network meeting on Monday in Abuja to provide quality prevention and management of fistula and female genital mutilation in Bauchi, Ebonyi, Kebbi and Sokoto states and the FCT.

The meeting was organised by the Federal Ministry of Health in collaboration with Momentum Safe Surgery in Family Planning and Obstetrics (MSSFPO) project, an international NGO.

The five-year project being implemented by EngenderHealth, another NGO is to improve access to safe obstetrics surgery.

Dr Kabiru Attah, MSSFPO Project Manager in Nigeria said the meeting would enable medical professionals and social workers to achieve quality and holistic fistula care for patients.

He lamented increasing number of new cases of obstetrics fistula in Nigeria in spite of efforts to eliminate the scourge.

“We currently have more than 12,000 cases of fistula in Nigeria.

“If the global plan to end fistula by 2030 is examined, one would realise that Nigeria is lagging behind.

“There is a need for this kind of meeting so that we can review what we have done and bring relevant professionals together to address the issues.

“We will examine how to raise financial and technical resources to ensure that Nigeria meets the 2030 target to end fistula,’’ he said.

Attah highlighted some of the challenges affecting the set target to include coordination within the sector and migration of medical workforce to other countries.

“Nigeria needs to begin to look inward and shift some skills to nurses; for instance physiotherapy.

“Nigeria needs to quickly empower medical officers with certain skills to be able to address some of the issues surrounding fistula.

“Until this is done, we will continue have fistula victims who do not have access to timely care,’’ he said.

Attah also stressed that fistula required a holistic approach to its management.

“It requires the medical or physical aspect, physiotherapy, social welfare, and empowerment and reintegration strategies to restore the dignity of survivors.

“On preventive measures, we need to look at the entire health care system and examine how to empower it to provide timely care for women when they enter prolonged labour,’’ he said.

In her remarks, Mrs Tinuola Taylor, Director and Head of Reproductive Health at the Federal Ministry of Health, noted that obstetrics fistula is a big problem in Nigeria.

She observed that if Nigeria could repair only 5,000 fistula cases out of 12,000 new cases recorded yearly, it would take the country several years to get rid of the problem.

“That is why we need to work so hard beside surgeries and repairs. We have to focus on prevention to stave off new cases.

“All stakeholders, including communities, traditional and religious leaders need to join hands with medical personnel to tackle the causes of obstetrics fistula,’’ she said.

Taylor stressed the need to retrain skilled birth attendants, promote family planning, discourage early marriage, and promote girl-child education and more sensitisation on the causes of obstetrics fistula.

Also addressing the meeting, Prof. Ojengbede Oladosu, an Obstetrics and Fistula surgeon, called for improved funding for the health sector, the retraining of skilled birth attendants and increased manpower to reduce fistula cases.

“Cases of unwanted pregnancies also require attention because when the pregnancy is unwanted, it is not cared for,’’ he said.

In another submission, Dr Halima Mukaddas, Medical Director, National Obstetrics Fistula Centre, Ningi, Bauchi State, said the centre handles between 50 cases and 100 new cases of fistula surgery monthly.

“We are still confronted with challenges because some people think obstetrics fistula is not preponderant in Nigeria.

“As many as 50 to 100 repairs are done in a month. These are figures that should be wake-up call for us as a country,’’ she said.

Mukaddas appealed to governments and partners to ensure that women, especially in rural areas have access to obstetrics and other healthcare facilities.

“Those in rural and hard-to-reach areas must be reached with emergency obstetrics care.

“We have midwives in different rural facilities; they are supposed to be retrained to enable them to detect complications early enough and make referral.

“A comprehensive referral mechanism should be in place such that there are vehicles to take needy women to secondary health facilities,’’ she added.