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

There has been a shift in focus from a primarily

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years with sizable international and domestic support. There has been a shift in focus from a primarily treatment orientated approach to one that also addresses prevention and rehabilitation issues. In 2004, HFE embarked on a major expansion program with the establishment of five regional facilities focusing on fistula repair, community mobilization and prevention. In 2007, they also opened the first private midwifery training college in Ethiopia. The MoH, in 2010, launched a human resources strategy to accelerate the training and deployment of midwives to each health centre and to deploy health officers with emergency surgery skills. AusAID Health Resource Facility 45 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 USAID has been supporting the Government of Ethiopia’s efforts to address fistula problems through various projects including through support to: Hamlin Fistula Ethiopia; the Fistula Care Program (Oct 1, 2007 - Sept 30, 2013) with EngenderHealth and IntraHealth; the Integrated Family Health Project (IFHP), Evidence to Action (E2A), (June 25, 2008 – Dec, 2013) with Pathfinder/JSI. The Australian Government through AusAID is a longstanding and significant supporter of HFE, having contributed more than AUD$10 million over the past 20 years. Funding has supported major expansion works including increased facilities at the main hospital and the construction of the Desta Mender rehabilitation centre. In 2011, AusAID entered into a longer-term commitment to fund an integrated fistula prevention and treatment program with a stronger focus on supporting greater alignment and coordination between HFE and Ethiopia’s Ministry of Health. FINDINGS The incidence of obstetric fistula (OF) has been the subject of speculation since it is not possible to follow births prospectively in a country with such a low rate of institutional birth and skilled attendance (no more than 5% institutional births and 1% SBA in home deliveries in the rural areas). As a proxy, the team used the proportion of obstructed labour as a base for high-risk births, and applied the WHO-established rate of fistula incidence for neglected obstructed labours, removing the (small) proportion of those that benefitted from Caesarean section. The computation resulted in an incidence between 3,300 and 3,750 new cases per year during the baseline year of 2010. The range takes into account different assumptions and regional variations, and is centred around 3,500, which is far below the previously reported number of 9,000 new cases per year, found in the Frances Donnay. UNFPA: Oral presentation of the Campaign to End Fistula, New York 2003” and/or “Media advisory documents: Launch of the Campaign to End Fistula, New York, 2003.” For examples, see the website: http://www.endfistula.com/natalie/Ethiopia.htm .
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