The Fate of Obstetric Fistula: Towards Equity, Education, and Policy in the Sylhet Region of Bangladesh

Abstract

This project will describe a review of literature and recommendations for obstetric fistula prevention programming and policy in the Sylhet region of Bangladesh. In order to better understand the social implications that women suffering from obstetric fistula face, an analysis of the interpersonal health communication topics of stigma, disclosure, coping, and identity will be conducted. Obstetric fistulas are an issue of health equity for women in resource-poor settings across the globe. An obstetric fistula is a hole that forms between the vagina and rectum or bladder as a result of prolonged obstructed labor, leaving a woman incontinent of urine, feces, or both. It is estimated that more than two million women currently live with untreated obstetric fistulas in sub-Saharan Africa and Asia (countries with the highest prevalence). The Sylhet region of Bangladesh has been disproportionately impacted in comparison to other regions. There are currently 70,000 women in need of fistula repair surgery and approximately 2,000 new cases of fistula develop every year. Only about 40% of births are attended by skilled personnel and the lifetime risk of maternal death is approximately 1 in 240. Programming recommendations include raising awareness on fistula prevention by training skilled personnel on the signs/symptoms and treatment options. Training community health workers on access, signs, and symptoms of obstructed labor provides an opportunity for depth and breadth of community-based prevention efforts. Training lay individuals to become skilled birth attendants is essential given the lack of midwives and health professionals in rural areas. Health and education policy should focus on training and access for all women at national and regional levels.

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