Photo credit: Dima Gavrysh/On behalf of UNFPA

The existence of fistula is the barometer of maternal health in the country. If year by year fistula decreases, we know that maternal health is improving. Dr. Kalilou Ouattara fistula surgeon, Mali Photo credit: GMB Akash/Panos Pictures

26-year-old woman, Equatorial Guinea I endured 5 days with delivery pains. I was finally transferred to the hospital and the foetus was dead. After 3 weeks, I started to feel constant flows in my vagina, and the odour was very bad. The situation has persisted for 10 years.

Photo credit: Richard Stanley Photo credit: Sven Torfinn/Panos Pictures

Photo credit: GMB Akash/Panos Pictures

22-year-old woman, Bangladesh Woman, Your country Nobody wants to stay with me due to the smell of urine. Even my husband sometimes blames me for my condition. Insert quote from woman in your country here.

Man, Cote d’Ivoire A woman’s primary doctor is first and foremost her husband. It is necessary that the husband support his wife before or after awareness of the condition. Photo credit: Lucian Read/WpN/On behalf of UNFPA

Usually the woman provokes this. When she leaves her husband and has sexual relations with another man, it happens that her husband will cast a spell on her and she will have a fistula. Elderly woman, Burkina Faso Photo credit: Richard Stanley

The results of [pregnancy] management by TBAs are disastrous due to the delays. They [wait] too long, do not know where to start, and do not even know where to stop. Health care provider, Kenya Photo credit: Dima Gavrysh/On behalf of UNFPA

OB/GYNs have shown little interest in learning how to perform fistula repairs. Even providers who have the skills to do simple repairs refuse. One probable reason is stigma. Health care provider, Mozambique Photo credit: Richard Stanley

Eritrea:Reintegration and counselling Ethiopia:Comprehensive fistula treatment Malawi:Community empowerment to strengthen health care provision Niger:Social rehabilitation and reintegration Sudan:Midwifery school system

1.Promote legislation and policies to reduce maternal mortality and morbidity, and address underlying socio-cultural factors. Photo credit: GMB Akash/Panos Pictures

Strengthen health care system capacity to: 2. Provide skilled maternity care that is accessible, affordable and culturally acceptable. 3. Manage obstetric fistula sensitively, ensuring that care and treatment are subsidised and accessible.

4. Raise awareness of reproductive rights to address obstetric fistula. Photo credit: Richard Stanley

5. Promote and empower the reintegration of women into communities post-surgery. 6. Involve women who have lived with fistula as equal participants in maternal health programme planning, implementation, and evaluation.

7. Promote partnerships to share key lessons and to catalyse collective action. Photo credit: GMB Akash/Panos Pictures

8. Support research on the social, cultural, economic and political factors related to obstetric fistula. Photo credit: GMB Akash/Panos PicturesPhoto credit: Lucian Read/WpN/On behalf of UNFPA

Insert presenter’s contact information Photo credit: Lucian Read/WpN/On behalf of UNFPA