African Health Specialists Adopt the Johannesburg Call to Action on Ending Fistula

JOHANNESBURG, South Africa — African governments should urgently ensure the rapid implementation of national and regional programmes to address maternal health and obstetric fistula, according to participants at the African Regional Workshop on Making Motherhood Safer by Addressing Obstetric Fistula.

In a Call to Action adopted at the close of their four-day meeting on 26 October, the participants, including more than one hundred senior officials from the ministries of health of 34 countries, international agencies and non-governmental organizations (NGOs), agreed that actions taken to eliminate fistula will help achieve international commitments on development, and particularly improve the health of mothers and infants, as well as address gender and economic inequities. They also called on African governments to strengthen and scale up national health systems and to especially ensure women’s right to access reproductive and maternal health services. This should be further enhanced by ensuring free or subsidized Caesarean sections, delivery care and fistula treatment.

Other recommended actions for treating and preventing fistula and enhancing maternal health care include: urgently addressing shortages in health-care personnel, which have been compounded by the lack of investment in human resources and the loss of these personnel to HIV and AIDS and “brain drain”. Participants also recommended ensuring access for all women with fistula to comprehensive treatment, including quality medical care, counselling and mental health services, health education, and social re-integration support.

Obstetric fistula is a major injury and disability to women who survive childbirth, altering lives of more than 2 million women worldwide, the majority of whom live in Africa. It is associated with stillbirths and poor prenatal health. Major contributing factors include poverty, illiteracy, low status of women and gender inequality, as well as limited geographic, financial and socio-cultural access to family planning and to emergency obstetric care.

To overcome these impediments, the participants called on African governments to adopt a more comprehensive approach to deal with fistula, including promoting girls’ education, delaying the age of marriage and childbearing, promoting gender equality, addressing harmful cultural practices, and fostering community awareness and mobilization. They especially called for the participation of men in eliminating fistula, fostering strong partnerships with civil society, NGOs and donors, and empowering women living with fistula for advocacy and peer support.

In her closing remarks to the workshop, Fama Hane-Ba, Director of Africa Division at UNFPA, the United Nations Population Fund, commended the participants for their work, especially the Call to Action and the drafting of an African regional strategy for the elimination of fistula, which she described as a milestone in efforts to rid women of the scourge. She also pledged UNFPA’s full support to governments, NGOs and civil society in the treatment and prevention of fistula.

The four-day workshop was aimed at sharing experiences from fistula programmes in the region and to draw lessons learned with a view to guide programming; exploring how fistula can be an entry point for improving maternal health; and to build consensus on preliminary works towards the development of a draft Regional Strategy for Fistula Elimination.

UNFPA is currently leading a global Campaign to End Fistula, involving a wide range of partners. Launched in 2003, the Campaign focuses on three main areas: preventing fistula from occurring, treating women who are affected and supporting women after surgery so that they can be successfully reintegrated into their families and communities. Learn more at www.endfistula.org.

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Contact Information:

South Africa: George Ngwa, tel. +27-12 354 8405 (office), + 27-72 617 1032 (cell), ngwa@unfpa.org

New York: Omar Gharzeddine, +1 212-297-5028, gharzeddine@unfpa.org; Micol Zarb, +1 212-297-5042, zarb@unfpa.org