Ghana achieves a 50 percent reduction in obstetric fistula cases

Ghana has achieved a 50 percent reduction in cases of obstetric fistula in five years under the Ghana Obstetric Fistula Prevention and Management Plan (GOFPMSP), the Ghana Health Service has said.

The GOFPMSP 2017-2021, developed after a global call in the fight against fistula was to establish and maintain sustainable funding mechanisms to halve obstetric fistula cases in Ghana by the year 2021 as well as eliminate the condition by 2030.

It was also aimed at preventing obstetric fistula, improving case identification and referral, providing treatment and care for all women with obstetric fistula, and providing rehabilitation and reintegration for each client and support for the caregiver.

Professor Sebastian Eliason, Consultant for the strategic plan made this known in a presentation at the fourth Maternal, Child Health, and Nutrition (MCHN) Conference 2023 organized by the Ghana Health Service in Accra.

The three-day conference was on the theme: “Strengthening service delivery for quality and accessible RMNCAH&N outcomes to meet the SDGs midpoint and beyond”.

It sought to reflect on new initiatives and strengthening of all levels of the health system with a special focus on the sub-district level of service delivery.

An obstetric fistula is a severe medical condition in which a fistula (hole) develops either between the rectum and vagina (recto-vaginal fistula) or between the bladder and vagina (vesico-vaginal fistula) after complications resulting from childbirth.

According to the World Health Organization (WHO) between 50 000 to 100 000 women worldwide are affected by obstetric fistula annually.

However, a 2015 Ghana Health Service/UNFPA report, estimated that 1,300 new cases of obstetric fistula are recorded annually with 1.6-1.8 cases occurring per 1000 births.

Dr. Eliason said the achievements were made due to improvements in obstetric care, an increase in antenatal attendance, an increased number of midwives in both CHPS compound and health facilities, and enrolment of obstetric fistula onto the National Health Insurance Scheme, among others.

He explained that in 2017 when the plan was initiated the number of obstetrics fistula cases reported reduced from 540 to 206 in 2021.

He noted that despite the success chalked there was still a backlog of cases due to inadequate treatment outreach and Obstetric Fistula (OF) surgeons, poor referral of identified cases, inadequate and unsustainable funding mechanisms, and inadequate partnerships for OF, among others.

He called for awareness creation and education about OF, a comprehensive mentorship program for training district doctors and residents in obstetric and gynecological surgeries, prioritized resource mobilization, and new OF partnerships to effectively implement the new strategic plan.