Family planning strategy to reducing obstetric fistula
Gyanecologists have described family planning as best strategy to reducing fistula cases among the women of reproductive age in Nigeria.
The gynaecologists noted that it is very important that the husbands should support their wives to adopt the necessary family planning methods as healthy spacing of pregnancy increases chance of healthy outcome for both mother and child.
Meanwhile, the number of women suffering from obstetric fistula in Nigeria is estimated at between 120,000 to 150,000 annually.
Gynaecologists encourage husbands to choose life for their wives by avoiding sex until six months after repair and another six months before conception while the woman will be on a child spacing method.
According to Wikipedia, the Latin word fistula literally means tube or pipe.
In medicine, a fistula is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injury or surgery, but they can also result from an infection or inflammation. Fistulas are generally a disease condition, but they may be surgically created for therapeutic reasons.
Obstetric fistula (or vaginal fistula) is a medical condition in which a fistula (hole) develops between either the rectum and vagina or between the bladder and vagina after severe or failed childbirth, when adequate medical care is not available.
The gynaecologists who spoke at the media roundtable discussion on fistula intervention titled “Family Planning and Fistula” held in Abakaliki, Ebonyi State. The event was organised by Engender Health and Fistula Care Plus.
The programme, which featured Journalists, from different media houses across the country as they went on facility visit at National Obstetric Fistula Centre Abakaliki, where fistula clients are been repaired and treated.
According to a reproductive health and family planning advisor with Engender Health, Olajumoke Adekogba, family planning is a strategy to reduce maternal morbidity and mortality.
Adekogba said: “Concerning family planning there are a lot of women who are bias because of religion. Some of them are ignorant while others lack awareness. When we started our activities in Ebonyi State we started by training personnel so that they can offer safe care because our organization is concerned about safety and quality of care. So we train the personnel on how to counsel the potential users of family planning. We train the personnel to counsel users on long term and we have done a lot of activities in terms of social mobilization, family planning outreach events. Using the already trained personnel to mobilize women in the community to access family planning which is child spacing in the state.
“We have a programme called integration of family planning into the fistula care and other reproductive health. So far we have trained people all over the states we operate including Ebonyi State here. We used to do follow up with fistula clients after repair, we counsel the clients about the benefits of family planning especially when they need to stay away from pregnancy for six months after resumption from sex. The clients are complying with the counseling.
“Women especially child bearing age should avoid following misconception against family planning. Women of reproductive age should visit clinics for family planning and see health provider that is proficient to enable them to get adequate information about child spacing so, that they can make their choice for themselves. They should try as much as possible to make a positive influence from their peer group because we have a lot of negative influence from peer groups and it is affecting women of reproductive age in child spacing.
“Child spacing would help women to rest between one pregnancy and another it would give the women opportunity to have exclusive breastfeeding with their child and it guarantees good health for the mother.
“Any woman can develop fistula irrespective of education and age if the awareness is not there, the person would develop fistula. As we know that fistula is a hole caused by prolonged obstructed labour. So if you have too early and too frequent of pregnancies fistula can occur”.
Country Project Manager, Fistula Care Plus, who is also a gynaecologist, Dr. Habib Sadauki, said Fistula Care Project is a five years programme and has funded 11 healthcare centres in ten States in Nigeria to treat fistula which include Kebbi, Sokoto, Zamfara, Kastsina, Kano, Bauch, Kwara, Oyo, Ebonyi and Cross Rivers States
Sadauki said: “Fistula is life shattering for women who experience it. It leaves a woman with chronic incontinence, which often results in social isolation. Other consequences for the woman may include frequent ulcers and infections. Kidney disease, possible paralysis, and even death; women with obstetric fistula usually have a stillbirth, so she and her family also experience the loss of a child.
“Survivors of traumatic fistula must endure the physiological trauma and stigma. Women with fistula may limit their liquid and food intake to stem the symptoms of fistula, resulting in further damage to her bodies. Some are abandoned or neglected by their families and secluded lives and are among the most impoverished and vulnerable members of society. Therefore family planning can help to reduce fistula cases.”
He continued: “Under fistula care, the Nigeria programme has delivered healthcare closely with partners at federal, state and community levels to achieve remarkable success in fistula service delivery which include prevention, treatment, rehabilitation, research and innovation. Since then, fistula service has expanded to States spread across six geo-political zones of the country.
“From 2007 to 20013, fistula programme has supported 9,203 fistula repairs at 10 facilities in Nigeria in partnership with Federal and State Ministries of Health and that of Women Affairs and Social development.”
A Consultant Gynaecologist at National Obstetric Fistula Centre Abakaliki, Dr. Yakubu Emmanuel, said the hospital started as initiative of former Governor of Ebonyi State, Chief Martins Ilochi, and it was meant to take care of fistula clients in the state which started in 2011. He said that the centre was later transformed into a national centre.
Emmanuel said: “The mandate we have here is to treat women with fistula related with child birth again to work towards preventing it because managing is not just enough. We also work towards rehabilitating these women because most of them are from low social economic backgrounds. In several reasons the clients are unable to carter for themselves so, we are into certain programmes to rehabilitate these women. We do all the programme along side with family as a prevention to reduce the rising case of fistula….”
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