BY PRUDENCE IJAH, ABUJA
The Minister of state For planning, Hajia Zainab Ahmed has pledged the commitment of the federal government towards the reduction of rising cases of vesico vagina fistula in the country.
While admitting that Obstetric Fistula is still very common in the North Eastern part of the country, Zainab explained that adequate measures are in place to ensure that vesico vaginal fistula is drastically reduced.
“The country is at the step of mitigating this harmful practice in the country. We are working towards giving them the necessary support that will boost their self esteem after passing through this ordeal.
We are making them to see the enormity of the problem and the need to be properly informed to take the right decisions”
According to her, poverty,and socio cultural practices and early child marriage are some of the factors contributing to the rise in Fistula cases.
“We are educating the families and the women on the consequences of early child marriage and the resultant effect. Girls who get married at a very early age,have a higher risk of obstructed labour because the birth canal is not fully developed”
The United Nations Population Fund (UNFPA), Acting Country Representative in Nigeria, Dr. Eugene Kongnyuy, stressed the need to create more awareness on obstetric fistula in Nigeria.
He said, “It is important to focus on improving Girl- Child Education, Child spacing, Gender trust and the need for people to be more compassionate”
In his address, a Professor of Obstetrics and gynecology from the college of medicine, University of Ibadan Professor
Oladosu Ojengbede hinted that annually the country has 12,000 new cases of Fistula every year. He explained that about 5,000 of the cases are treated ,and a shortfall of 7,000 cases are not treated.
He added that the most common causes of Obstetric Fistula is prolonged obstructed labour, as this accounts for 65.9% -96.5% of cases in Nigeria.
The Erudite Professor however bemoaned the fact that majority of the health facilities do not have 24 hours services with which to attend to pregnant mothers.
“When there is no qualified skilled birth attendants to attend to the expectant mothers, they may end up having complications ,which may result into VVF. In some instances they have to undergo caesarean section (c-s)”
“According to UNICEF 2013 report, caesarean section in Urban area is 3.9%, while in rural areas is 1%. Poor access to quality caesarean section to relieve the obstruction is an issue in most cases”
The Minister of Health, Professor Isaac Adewole, has called for stronger awareness towards the elimination of Obstetric Fistula (OF) in Nigeria, adding that it would reduce the high indices of maternal mortality.
According to him, ‘’ Obstetric Fistula is a devastating Childbirth injury which leads to both physical and social harm for women. Women who experience obstetric fistula suffer constant inconvenience, shame, social segregation and health problems.
“The development of obstetric fistula is directly linked to one of the major causes of maternal mortality: obstructed labour. It is estimated that more than 2 million young women live with untreated obstetric fistula in Asia and Sub- Saharan Africa,’’ he added.
Prof. Adewole noted that “in Nigeria the most common cause of Obstetric Fistula is prolonged obstructed labour due to limited access to emergency obstetric care. Unfortunately only 38% of deliveries in Nigeria are supervised by Skilled Birth Attendants (SBAs). Socio- cultural practices including early marriage and early childbirth before the pelvis is fully developed also contribute significantly
He also said that according to a 2017 report by UNICEF, ‘’43% of Nigerian girls are married off before their 18th birthday, while 17% are married before they turn 15. The North Eastern and North Western Geo- Political Zones have the highest number of case’’
He emphasised that ‘’ an estimated 150,000 women and girls are living with untreated fistula in Nigeria, with an annual incidence of 12,000 -15, 000 cases, approximately, as Nigeria contributes 15% to the global burden of obstetric fistula’’.
He said ‘’ it is estimated that the unmet need for the treatment of obstetric fistula could be as high as 98% in Nigeria, with less than 3,000 fistula repairs done annually (NSF2018).
It is also estimated that about 2,000 fistula repairs annually (NSF 2018- 2022) and 10,000 clients are added annually to subsequent years new cases’’, he added.
To this end, the minister said that federal government and Development Partners are making concerted efforts to eliminate fistula and invest in capacity building of various cadres of Healthcare Workers.
He stressed that the FMOH had developed National Training Guidelines in conjunction with National Group on Obstetric Fistula, development partners, line ministries and other key relevant Stakeholders.
The Minister informed that the FMOH would established four more National Centres and one regional centre, in addition to the three National Centres ‘’ This will increase our national obstetric centres to eight including regional centre’’
He urged partners to join the fight against the scourge of fistula in the society, adding that FG would continue to play a leading role in setting the agenda.