Safe Motherhood/Fistula and Maternal Health in Buyende and Kamuli

Reaching the Forgotten Face of Women and Girls with Fistula: Adapting Culture to Prevention of Fistula and Maternal Health Among People in Busoga Districts

Over the last 5 years Fistulas in Uganda has stagnated at 6.4% among women between 14yrs – 44yrs, and in Kamuli, a slight rise in has been recorded in Buyende. Fistulas in Uganda among Rural women is growing fastest especially in villages where there is no nearby qualified health workers and medical services. The groups facing fistula includes women, teenage mothers and younger girls above/below 18 years. Currently Fistula has lead to break up of marriage or relationships, widowed, divorce or separated, orphans, single mothers and father’s home life style. Research has also shown that risky sexual behavior, lack of medical services supplies and treatment, women slavery home works, traditional thinking, poverty, early marriage and pregnancy causes fistula to be a recurring health problem. Moreover, these higher risk sexual practices are common in Kamuli and Buyende Districts, Eastern Uganda. For instance, Kamuli district has the highest number of single orphans without mothers, families cared by father without mother, high maternal death, high fertility rates, in
Uganda, which is a pointer to high death of women caused mainly by fistula and HIV/AIDS, because in Uganda’s situation, pregnancy is one of the most objective indicators of unsafe sex practices. 

Moreover, this particular group has hitherto been relatively underserved with anti-fistula and maternal health messages and services. Most anti-Fistula messages and health services have not focused on this particular group, consequently contributing to the increase in fistula among rural/villager women.

Additionally, only 12% of the population countrywide is aware of their Fistula status,. As a result, services to reach this particular group are still limited, and in need of scaling up. These gaps in service delivery provide challenges as well as opportunities to reach out to this underserved
rural/villager women and girls population. 

Using participatory, culturally adapted and gender sensitive approaches, this project will address these gaps by reaching out to this hitherto underserved group with culturally relevant and appropriately tailored Fistula and Maternal Health Problems (FMHP) messages and services. The
main approach will be to integrate Fistula as part of a comprehensive reproductive health package to the target population. URICT-Uganda in collaboration will carry out the interventions with its partners. They will include culturally sensitive information and behaviour change messages
on safer sex practices, services to address gaps in Fistula management/treatment, Refer women with 

Fistula to get treatment in Kamuli Mission Hospital, family planning. URICT is a proven leader in SRHR in Kamuli Eastern Uganda, and its static Rural Health Center in Kitayunjwa Sub-county, Busota Village, and Kamuli District will act as focal points for accessing care and delivering services to communities that are more distant. 

Project Goal

The goal is to contribute to a reduction in the of Fistula among rural/villager women and teenage mothers, by promoting Fistula and maternal health Education and Outreaches, Training Traditional Birth Attendants (TBAs) will change rural women health practices. It is expected that this intervention will contribute to Fistula reduction, increase Safe motherhood health method use and promote greater use of TBA’s services in the villages as immediate nearby medical health solution.

Area of Coverage

The coverage area is in Kamuli and Buyinda districts respectively. In Kamuli the area of coverage will include 3 sub counties, namely Mbulamuti near banks of lake Kyoga, Butansi and Kitayunjwa. In Buyinda the area of coverage will be Nkondo and Bukungu and Irundo sub counties all near
lake Kyoga. The secondary target will be the opinion leaders and political leadership in the area to know the urgent need for opening a fistula hospital in Busoga Region to save mothers of the world dying every day in big number.

Strategic Partnerships

Strategic partnerships has been already established with Kamuli General Hospital and the respective district/local Health Leaders, The AFYA American Foundation, Uganda Injure Birth Project UK (Dr. Brian Hancock, Dr. Glyn Constantine and Nurse Brenda U.K) TASO-Jinja to cater for HIV affected women needs, and the St. Francis Hospital Njeru Jinja (SFH) to  provide care and support women with Fistula and Maternal Problems