Kenyan midwives back global campaign to end obstetric fistula
Midwives from the Lugina Africa Midwives Research Network (LAMRN) are backing the United Nations’ International Day to End Obstetric Fistula – a devastating medical condition affecting thousands of women in Sub-Saharan Africa.
In a statement to newsroooms, the organisation said obstetric fistula is one of the most tragic, but mostly preventable, childbirth injury caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.
“It leaves women with incontinence problems, and often leads to chronic medical problems, depression, social isolation and deepening poverty. Most women who suffered fistula have also a higher risk of giving birth to a stillborn baby, adding trauma and stigma to their life,” the statement reads.
In Kenya, as part of a four-year programme on stillbirth prevention and management in Sub-Saharan Africa, LAMRN said its midwives have been working with women, family members, and health professionals at Kisii County Hospital to develop a support package for women who experience stillbirth and suffered obstetric fistula.
Funded by the National Institute of Health Research, the multi-country research programme has been led by midwives from Liverpool School of Tropical Medicine (UK) and six African countries: Malawi, Kenya, Uganda, Tanzania, Zambia and Zimbabwe
The study conducted in Kisii County is one of the first to address the double plight of obstetric fistula and stillbirth.
Samuel Kimaiga, Principal Nursing Officer at Kisii Hospital, Kenya, said: “The plight of women with obstetric fistula cannot be over emphasised. Around 30% of cases will heal spontaneously with in-patient hospital care, however bereaved mothers often don’t access the care they need at the right time because of taboo in their communities and a lack of information about where to get help.”
This package of support involves helping change behaviours and attitudes of providers to improve communication about the death of the baby and the diagnosis of obstetric fistula and its surgical repair; building community health worker capacity to share information and follow up after discharge from hospital and encouraging hospitals to guarantee privacy for women.
It also aims to strengthen existing support groups to help women redeem their self-esteem and exit seclusion, and challenge negative practice through community dialogues and radio campaigns.
The Regional Coordinator for the NIHR Stillbirth programme, Dr Sabina Wakasiaka said: “The country leadership, county chief executives and community members continue to embrace and support midwives in promoting and enhancing better care for parents experiencing fistula and stillbirths, which can only be a good thing for the future.
Samuel Kimaiga added: “Through this study we have raised awareness of the help available and brought onboard a team of specialists at Kisii Hospital to care for women more quickly which has had a huge impact. The number of women we’ve been able to treat has increased tremendously – more than 570 women have been given a new lease of life and can now interact with others in the community without stigmatisation.”
As part of the NIHR Programme, other research studies on stillbirth, conducted across the network, have looked at the way stillbirth is communicated to families, the risk factors associated with stillbirth, the experiences of fathers, and the creation of a bespoke board game which helps train midwives around aspects of respectful care.
This research was funded by the National Institute for Health Research (NIHR) (16/137/53) using UK aid from the UK Government to support global health research.
The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.