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Zambia renewed its commitment to end obstetric fistula as a public health problem in the country by 2030.
On May 23, 2023, Zambia commemorated the International Day for Elimination of Obstetric Fistula with the theme “20 years on — progress but not enough! Act Now to End Fistula by 2030”.
The ministry of health launched a new framework Obstetric Fistula Strategic Plan for the period 2022 to 2026.
Obstetric fistula is a medical condition in which a hole develops between the birth canal and bladder and / or rectum. It is caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.
Globally, over two million women live with obstetric fistula with the majority of the cases being from Africa.
In Zambia, as of 2018, more than 33,000 women and girls had been affected.
The new strategic plan was developed by the country’s ministry of health and the United Nations Population Fund.
It marks a major milestone for the Fistula Foundation Treatment Network in Zambia and will serve as a guiding tool for healthcare providers across Zambia, the
Direct causes of fistula include childbearing at too early an age, malnutrition and limited access to emergency obstetric care. Some of the indirect causes, such as poverty and lack of education, prevent women from accessing services that could preclude the onset of such conditions.
The Zambia Demographic Health Survey 2018 indicated that childbearing in Zambia begins early, with more than a third of women giving birth by age 18 and more than half giving birth by age 20. Around 47 per cent develop fistula during their first pregnancy.
In Zambia, only half of the women in rural areas deliver with a skilled birth attendant, leading to high rates of maternal mortality and childbirth injury, such as obstetric fistula.
Before the launch of the Fistula Foundation’s treatment network in 2017, there were only four trained fistula surgeons in the entire country, severely constraining women’s access to timely, fistula care.
Moreover, there is limited data on the magnitude of obstetric fistula cases in Zambia, making it difficult to design management interventions.
There are also few research studies on obstetric fistula conducted in Zambia. Therefore, there is a need for more studies that close the knowledge gaps in prevention, treatment, rehabilitation that will accurately demonstrate the incidence and prevalence rate.
These kinds of studies can provide evidence-based information to assist with prevention, treatment, rehabilitation programming and policy decision making.
To make Zambia free of obstetric fistula, this new strategic plan provides direction for service delivery for fistula prevention, treatment, rehabilitation and reintegration as well as fistula research in the country.
The strategic plan will be applied to all levels of the Zambian healthcare system — national, provincial, district, health facility and community.