Obstetric fistula remains one of the most devastating yet preventable childbirth injuries affecting women across Africa. Caused by prolonged, obstructed labour without timely medical intervention, it leaves women with chronic incontinence, social isolation, and restricted livelihoods — deepening stigmatization within society. Addressing this condition demands more than just medical treatment. It calls for a comprehensive, systems-level response that restores dignity and reintegrates survivors into society.
This was the heart of the discussion at a parallel session hosted by Johnson & Johnson and Amref Health Africa at the Africa Health Agenda International Conference (AHAIC). Diverse stakeholders including government representatives, healthcare professionals, development partners, and the private sector gathered to demonstrate how addressing the social and ecological determinants of health has the potential to restore the dignity of women and girls while contributing to Universal Health Coverage (UHC).
A Human Rights and Social Justice Issue
Giving the keynote address, Mette Kinoti, Amref Health Africa Board Chair, reminded delegates of the urgency and collective responsibility to ensure no woman is left behind, a message that aligned with the conference’s theme of addressing the social and ecological determinants of health.
“In as much as obstetric fistula is a development issue, it is just as much a human rights and social justice issue for women across the continent,” she noted.
The Burden of Fistula and the Human Cost
The statistics are overwhelming: an estimated 50,000 to 100,000 new cases of obstetric fistula occur globally each year, with Africa bearing the brunt. According to the World Health Organization, for every woman who dies in childbirth, many more survive with debilitating injuries like fistula.
“For every woman who dies during childbirth, many more survive with devastating childbirth injuries. Obstetric fistula strips women of their dignity, leaving them with chronic incontinence, social isolation, and economic vulnerability,” Kinoti emphasized.
Her words underscored the urgency of addressing this neglected health condition — not just to save lives but to restore the quality of life for survivors.
A Holistic and Integrated Approach to Fistula Care
The session at AHAIC highlighted the importance of moving beyond surgical intervention to a more holistic approach that addresses prevention, treatment, and long-term support. Key strategies discussed include:
- Prevention Through Skilled Care: Ensuring every birth is attended by a skilled health professional and that emergency obstetric care is accessible. Addressing cultural practices like early marriage and adolescent pregnancies is also critical.
- Strengthening Health Systems: Integrating fistula care into routine health services and building the capacity of healthcare workers in prevention, early detection, and surgical repair. “We must institutionalize fistula care within our health systems to ensure timely and quality care for affected women,” emphasized Dr. Margaret Mutumba, a global health innovator and scholar.
- Leveraging Technology for Access: Mobile health innovations have proven to be powerful tools for raising awareness, tracking patients, and providing follow-up care. “We’ve seen how mobile health technology can be a game-changer. Through simple text messages and geolocation-based alerts, we’ve reached women in remote areas who would otherwise suffer in silence. Technology brings care closer and saves lives,” said Henry Kilonzo from Safaricom Foundation.
- Economic and Social Reintegration: True recovery goes beyond physical healing. Providing vocational training, microfinance opportunities, and entrepreneurial support enables survivors to rebuild their lives. “Economic empowerment changes everything. When women rebuild their livelihoods, they not only regain financial independence but also their self-worth and place in their communities,” explained Rhoda Ndakwe, Chief Community Development and Research Officer at CCBRT.
The Power of Partnerships
A recurring theme throughout the session was the need for multi-sectoral collaboration. No single organization can address the complex challenges of fistula alone. By bringing together government agencies, civil society, the private sector, and development partners, collective action can drive greater impact.
“We must harness the strengths of each sector — government investment, private sector innovation, and civil society’s community engagement. Together, we can build a sustainable model that ensures no woman is left behind,” stressed Anthony Gitau from Johnson & Johnson.
The Role of Data in Driving Action
One of the session’s key takeaways was the need for accurate data to inform decision-making and resource allocation. The true burden of fistula remains unclear in many countries, making it difficult to plan effective interventions. National surveys and rapid assessments are essential for identifying prevalence and targeting resources where they are most needed.
“We cannot eliminate what we do not know,” Rhoda Ndakwe emphasized. “Accurate data is essential for targeted interventions and sustainable change.”
Clarion call
As the global community works toward the goal of ending fistula by 2030, the time for action is now. We must move beyond isolated interventions and adopt a holistic approach that addresses the medical, social, and economic dimensions of fistula care.
The panelists called upon governments to prioritize fistula care in their health agendas, development partners to invest in long-term solutions, and communities to stand against stigma and support the reintegration of survivors. Strengthening data systems, investing in technology-driven solutions, and scaling economic empowerment programs must be central to these efforts.
“Together, we can transform lives,” Nakululombe Kwendeni, the session’s moderator and Technical Director RMNCAH/SRHR, Amref Health Africa, concluded. “When we restore the dignity of women, we strengthen families, uplift communities, and drive sustainable development.”
Nyambura Gitonga, Communications, Amref Health Africa in Kenya