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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


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    Presentation Transcript
    1. Fistula Program in Bangladesh Prof. Sayeba Akhter

    2. Scenario of Fistula Patient

    3. Bangladesh Initiatives

    4. Estimation of Fistula prevalence No of estimated women living with fistula are about 71,000 (EH in 2003).

    5. Global Approach PREVENTION TREATMENT FISTULA Advocacy REHABILITATION

    6. Prevention

    7. 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

    8. Religious Leader

    9. 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

    10. 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

    11. Fistula Prevention Materials

    12. Treatment

    13. 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

    14. Ten Obstetric Fistula Corners at Government. Medical College Hospitals RMCH, Rangpur MAGOMCH MMCH SZRMCH RMCH NFC, DMCH SSMCH SBMCH KMCH CMCH

    15. 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

    16. Guest Visited at Dhaka Medical College Hospital

    17. 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

    18. 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

    19. Fistula Camps Class Room Session Orientation Session Patients Screening Spinal Anesthesia Fistula Operation Post-operative Hands on Skill Fistula Patients Travel Allowance

    20. 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

    21. Capacity of Service providers increased in 10 Medical College Hospitals of the Country 22

    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

    23. South South Collaboration Training of Foreign Gynecologists , Anesthetist & nurses - Afghanistan - Pakistan - Nepal - East Timor -Malaysia -Singapore -UK --__

    24. Rehabilitation and Reintegration