Obstetric fistula is a complication of childbirth, seen predominantly in Africa and some parts of Asia, with devastating physical, psychological, and social effects on women and their families. In the U.S. Congress, there is considerable interest in providing aid to eliminate the condition. This GHJP project was the result of a request from a Congressional office seeking input for a draft bill addressing obstetric fistula in Africa.

An interdisciplinary team of students from the GHJP talked to dozens of researchers, advocates, clinicians, and government officials to develop a critique of the current draft legislation and a roadmap for moving forward with a more effective, sustainable, and accountable intervention. In short, the GHJP team has recommended shifting the current draft bill away from a singular focus on surgical repair of obstetric fistula by U.S. doctors and toward a broader effort that, in addition to treatment, involves preventing fistula by training local healthcare workers and enhancing emergency obstetric care. This effort would also involve reintegrating women who have received treatment back into their communities. The main five recommendations from the GHJP's findings are that Congress should focus on:

Providing the appropriate level of funding to prevent and treat fistula.
Expanding the availability and improving the quality of emergency obstetric care by focusing fistula prevention efforts on integrated rather than vertical programs.
Creating sustainable programs to combat fistula by building the capacity of local health workers and capitalizing on existing efforts and expertise.
Promoting community health education on fistula.
Providing social, economic, and psychological support for the reintegration of women post-surgery.​

Publications


Drakes, J. and Jim, Y-H. "A Full-Spectrum Approach to Eliminating Obstetric Fistula: How the United States Can Make Its Best Contribution" Global Health Justice Partnership Working Paper (2013) (Drakes, J. and Jim, Y-H. "A Full-Spectrum Approach to Eliminating Obstetric Fistula: How the United States Can Make Its Best Contribution" Global Health Justice Partnership Working Paper (2013) (available here).