Fistula Program in Bangladesh. Prof. Sayeba Akhter. Scenario of Fistula Patient. Bangladesh Initiatives. Estimation of Fistula prevalence. No of estimated women living with fistula are about 71,000 (EH in 2003). Global Approach. PREVENTION. TREATMENT. FISTULA. Advocacy.
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Fistula Program in Bangladesh Prof. Sayeba Akhter
Estimation of Fistula prevalence No of estimated women living with fistula are about 71,000 (EH in 2003).
Global Approach PREVENTION TREATMENT FISTULA Advocacy REHABILITATION
Prevention • Free female education up to grade XII • Raise Public awareness and Delay marriage • Increase no of Skilled birth attendance both community/facility • Facility development & training-EmOC, midwifery (FWVs-1500) • Involvement of all stakeholders in Program Planning & Implementation
Contd.. Preventive Strategy • Demand side financing -Maternal Health Voucher Scheme for poor pregnant women. • Professional body’s participation in Government program-OGSB closely working with the GOB. • Community awareness program of EH about fistula issue • NGO’s involvement in safe delivery- BRAC, Marie Stop's. • Joint GoB UN MNH Initiatives
Advocacy & Awareness Programme • Advocacy & Awareness Programme - Divisional Level Seminar - Policy Level Workshop and Seminar • Media • - In Country - National and Local daily Newspaper and National TV Channel- • BTV, ATN, NTV, Channel-I, Tara TV etc. • - Abroad –BBC-Life • Orientation Orientation workshop on Fistula, 29 Sept., 2003
Treatment: • In National Fistula Centre • Medical College Hospitals – 10 Fistula Corners • Private and NGO Facilities-Kumudini, LAMB , Addin , Malumghat missionary, Mottalib , Taqwa hospital, MAMMS fistula and Birth Trauma Hospital
Ten Obstetric Fistula Corners at Government. Medical College Hospitals RMCH, Rangpur MAGOMCH MMCH SZRMCH RMCH NFC, DMCH SSMCH SBMCH KMCH CMCH
Private and NGO Fistula Service Sites LAMB Hospital Parbotipur, Dinajpur Kumudini Hospital Mirzapur, Tangail Ad-din , Dr. Muttalib Community, Taqwa , MAMMS Fistula and Birth Trauma Hospital at Dhaka Memorial Christian Hospital Chokoria, Cox’s Bazar
What we have achieved so far October’03-Dec’2010 Temporary GOB Facility Development at DMCH by UNFPA Funding, October, 2003-Separate Ward, Preoperative, Post Operative & OT. A). Facility Development-DMCH Post-Operative Fistula Ward Pre-Operative B). Equipment & Logistic Supply by UNFPA
Fistula Corner at 10 Medical College Hospitals • Need assessment done • Training of Doctors & Nurses • Upgradation of Facilities • Fistula Camp • On site training of Doctors & Nurses, orientation training of stakeholders • Fistula Follow-up Camp
Fistula Camps Class Room Session Orientation Session Patients Screening Spinal Anesthesia Fistula Operation Post-operative Hands on Skill Fistula Patients Travel Allowance
Training • Development of Log Book & manual -Doctors -Nurses • Data Collection Book-Fistula Record Sheet • Training of Doctors & Nurses conducted –national and international • Piloting of FIGO Manual
Capacity of Service providers increased in 10 Medical College Hospitals of the Country 22
Center How to Decentralize Service? Training of Key Persons in NFC Go back to concern center & start work Face problem Camp Network On site training Surgeons develop confidence Feel ownership & Partnership Advocacy
South South Collaboration Training of Foreign Gynecologists , Anesthetist & nurses - Afghanistan - Pakistan - Nepal - East Timor -Malaysia -Singapore -UK --__