International Day to End Fistula: Programs Find Innovative Solutions

Friday May 23rd marks the second International Day to End Obstetric Fistula, a day of awareness for a health challenge faced by millions of women worldwide. Obstetric fistula is a debilitating injury that occurs after prolonged, obstructed labor in which newborns are often stillborn and women are must suffer chronic incontinence, often in solitude and shame.  The likelihood of fistula is increased by poor prenatal care, early pregnancy, and lack of skilled birth attendants.

However, health innovators are hopeful. Fistula is easily repaired and highly preventable. Better prenatal care, reproductive health education, and giving birth in a health facility can all decrease the likelihood of fistula developing. These challenges are ripe for innovative solutions, and nine programs profiled in the CHMI database are developing new methods to find and treat women to ensure that fistula becomes a problem of the past. The programs below are working to combat the challenge of fistula with mobile health solutions and provider training. 


Mobile Money Transfers for Transportation

The Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) hospital and the Freedom from Fistula Foundation (FFF) in Kenya are two programs using mobile money transfers to offset the costs of transportation for fistula patients to seek treatment.

The Mobile Outreach Programme of the CCBRT in Tanzania focuses on finding women with fistula in the rural communities surrounding Dar es Salaam. Ambassadors in these communities identify women with fistula and notify the hospital, which then transfers funds through the Vodafone M-PESA mobile money system. The ambassador purchases a bus ticket for the women, and also receives a small monetary reward for their work and as an incentive to find more patients. Since implementing mobile technology solutions in 2009, the CCBRT has repaired almost 1000 fistulas, and 83% of those women were referred through the M-PESA system.

The program m-Money for Women with Fistula also relies upon the M-PESA system to reach fistula patients in urban areas surrounding Nairobi, Kenya. This program provides funds through mobile phone transfers for potential patients to visit partner hospitals for fistula screenings. If a fistula is confirmed, the women can receive funding for transportation to Nairobi for free treatment.  

Phone Hotlines

In Sierra Leone the Fistula Hotline utilizes a phone number to connect women with specialized nurses at a women’s center in Aberdeen to discuss concerns on fistula symptoms. The nurses on the hotline determine whether women are eligible for fistula treatment, and then connect them with more resources.

The m-Money for Women with Fistula program in Kenya also operates phone numbers to act as a fistula hotline for women in Nairobi. The numbers are advertised on public transportation mini-buses, and provide access for women through free calls and texts.


Provider Training

Women in Bangladesh can find support for fistula prevention and treatment through the Meyer Hashi Project. This project provides training for service providers and community health workers targeting obstetric fistula. The project focuses on education for patients and community members, and reinforces training for doctors and nurses in participating hospitals.


Learn more about the International Day to End Obstetric Fistula here, and explore the CHMI database to find more programs using creative innovations to end fistula and other critical health challenges.


Photo: Aberdeen Women's Centre © 2013 The Freedom from Fistula Foundation