April 19, 2024


A Professor of Obstetrics and Gynaecology, Oluwarotimi Akinola, has appealed to the federal and state governments to upscale emergency obstetric care toward eliminating obstetric fistula in the country.

He said this in an interview with the News Agency of Nigeria on Tuesday in Lagos, during the commemoration of the ‘International Day to End Obstetric Fistula’.

International Day to End Obstetric Fistula is celebrated annually on May 23, with this year’s theme as “End Fistula Now”

Obstetric fistula is a hole between the birth canal and bladder or rectum, caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.

It leaves women and girls leaking urine, faeces or both, and often leads to chronic medical problems, depression, social isolation and deepening poverty.

According to the United Nations Population Fund, 500,000 women and girls are estimated to be living with fistula globally, with approximately 50,000 new cases every year.

It stated that obstetric fistula is the most devastating of all pregnancy-related disabilities and that Nigeria accounts for 40 per cent of cases worldwide.

Prof. Akinola, who is the former National President, Society of Gynaecology and Obstetrics of Nigeria, said obstetric fistula constitutes a major public health problem in Nigeria and is prevalent in the Northern part of the country.

According to him, Nigeria’s target to eliminate obstetric fistula by 2023 is an illusion without the requisite investments and commitment to obstetric fistula prevention, noting that the country will continue to have incident cases.

Nigeria’s Obstetric Fistula Strategic Plan (2019 to 2023) has a vision of an obstetric fistula-free Nigeria with the objective of promoting 30 per cent reduction in the incidence of obstetric fistula.

It also has a target to reduce the backlog of untreated obstetric fistula cases by 30 per cent and facilitate rehabilitation and re-integration of 30 per cent of needy treated fistula patients within the planned period.

The plan was premised on the need to promote universal access to obstetric fistula prevention, quality treatment and rehabilitative services in line with the global campaign to end obstetric fistula by 2030.

“To achieve that, you must scale up your emergency obstetric care, which involves improving ante-natal clinic attendance; improving on the number of women that deliver in health facilities; increase the number of women whose deliveries are supervised by skilled birth attendants.

“The last two Nigerian Demographic Health Surveys (NDHS) haven’t recorded improvements in that regard.

“Delivery by skilled providers remains low at 43 per cent, even though the trend has improved from 39 per cent in 2008 to 43 per cent in 2018.

“Also, only 39 per cent of birth takes place at health facilities. Basically speaking, until we improve, we cannot meet the target.

“Besides, we can’t aim to achieve the set targets without reducing the number of underage pregnancies and teenage marriages.

“These are factors that can lead to situations where a woman cannot deliver by herself and in the absence of emergency obstetric care where caesarean section can be quickly activated, this mostly leads to complications or obstetric fistula,” he said.

The professor noted that any woman could develop fistula, he, however, said, “Adolescent or pre-adolescent girls whose bodies are not fully developed for childbearing are particularly vulnerable. This is why ending child marriage can help in the fight to end fistula.”

He noted that childbirth should be supervised by a skilled birth attendant, adding that complications could be detected early and appropriate intervention or referrals instituted.

The professor said that fistulas could often be repaired, however, many women and girls with the condition cannot access or afford the reconstructive surgery that will transform their lives and restore their dignity.

Meanwhile, data from UNFPA show that the average cost of fistula treatment was estimated at 600 dollars, which is beyond the reach of most women with the condition.

Prof. Akinola noted that the lack of availability of skilled practitioners and poor health-seeking behaviour of those affected with the condition was also a barrier to fistula repair.

He said that the International Federation of Gynaecology and Obstetrics was training and enhancing fistula repair among practitioners in Nigeria and Africa to bridge the knowledge gaps.

Prof. Akinola called for increased awareness on sexual reproductive health issues and strengthening of the healthcare system to provide accessible, affordable, quality maternal healthcare services.

He noted that implementing this would position the country on the path to meeting its target of obstetric fistula prevention, elimination and enhanced maternal health indices.



Leave a Reply

Your email address will not be published. Required fields are marked *