Female genital fistula predominately affects women who are marginalized within their societies and lack access to quality maternal health care. While efforts to promote fistula identification and treatment exist, systematic knowledge about the barriers women face in accessing fistula treatment is lacking, in addition to rigorous evidence about interventions that effectively respond to these barriers. A partnership between the Population Council and the USAID Fistula Care Plus project implemented by EngenderHealth sought to understand and address critical barriers to fistula care in Nigeria and Uganda. The study examined whether a comprehensive information, screening, and referral intervention reduced transportation, communication, and financial barriers to preventive fistula care and improved its detection and treatment. A complex social behavior change (SBC) intervention was implemented featuring a single screening algorithm applied through multiple channels, in addition to free transportation, to promote women’s improved access to fistula centers for diagnosis and treatment. As noted in this report, implementation of a complex SBC intervention is feasible in a controlled setting with sufficient resources, and effective when integrated within local, community-based health systems and partners.
Sripad, Pooja, Elly Arnoff, Charity Ndwiga, George Odwe, and Emmanuel Nwala. 2020. "Reducing barriers to accessing fistula repair in Nigeria and Uganda: An implementation research study." Washington, DC: Population Council.
Reducing Barriers to Fistula Care