joint-aus-us-gov-review-hamlin-fistula-ethiopia-final-report.doc

There are definitely important opportunities now for

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There are definitely important opportunities now for HFE’s closer engagement with FMOH and the technical agencies (UNFPA, WHO, JHpiego) to work towards the development of standardised government-owned standardised curricula. There is likely to be an over-supply of midwives in the next few years. 26 In this context, HFE needs to consider whether it is appropriate to train new midwives or collaborate with FMOH to improve the quality of the current workforce? Prevention education and case detection Both HFE and USAID-supported programs work through the Health Extension Program (HEP) (see Annex 6b) for awareness raising, case detection and referral among others. The important work of OF/FUI case detection is not however included in the HEW’s job description. FMOH is also working increasingly with traditional and religious leaders for the promotion of reproductive health, providing another opportunity for HFE to influence the messaging. The HEP covers most of the country and it is through strategic engagement with FMOH that HFE can influence the content of communications at the community level. 2.2. Program Delivery 2.2.1. Fistula repair from six HFE centres Fistula repair is the first of the five key objectives of HFE’s results framework (see Annex 9) and the foundation of HFE’s work. Most of the fistula patients are young women, but many are much older, either because they have lived in shame with their problem for many years or because they have fistula after numerous deliveries. A review of 32 years’ of data from HFE found that average age at occurrence of fistula is over 20 years, but one-third of the fistula patients were under 20 years. 27 The team was told that centres have seen patients as young as two years of age, with fistula in some cases caused by sexual abuse. 28 26 Personal communication, HR directorate, FMOH 27 USAID. Obstetric Fistula Situation Analysis. 2013 28 Anecdotal report from Mekelle. More detailed patient profiling would provide some useful information. AusAID Health Resource Facility 7 Managed by HLSP in association with IDSS
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AID and USAID Review of Support to Hamlin Fistula Ethiopia (Ethiopia) 31/05/2018 Services Order 230 Draft report The curative (treatment) goal is to reduce and eventually to eliminate the backlog of fistula cases by increasing the capacity of fistula centres (professional surgeons and nurses, number of beds and adequate facilities) for patients. Currently, there are six fistula hospitals/centres including the Addis Ababa Fistula Hospital, Bahir Dar, Mekelle, Yirgalem, Harar and Metu fistula centres. The number of beds (pre and post-operative) of these centres is close to 300. AAFH is not ‘ the only hospital currently in the world devoted to the care of these patients ’ as stated in the 2011 Strategic Plan, though the USAID situation analysis confirmed that HFE and (since 2010) the Women and Health Alliance are the only organisations in Ethiopia providing fistula surgery. 29 The team visited the Addis and Mekelle centres. Both these are in striking contrast to the
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