Rahel Nardos1,2,3, Fekade Ayenachew4, Renate Roentgen4, Melaku Abreha5, Laura Jacobson6, Amanuel Haile7, Yibrah Berhe7, Karen Gold8,9, W Thomas Gregory10, Theresa Spitznagle11,12, Christopher K Payne11,13, L Lewis Wall11,12. 1. Oregon Health & Science University, L466, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. nardosr@ohsu.edu. 2. Kaiser Permanente Northwest, Portland, OR, USA. nardosr@ohsu.edu. 3. Worldwide Fistula Fund, Schaumburg, IL, USA. nardosr@ohsu.edu. 4. Hamlin Fistula Ethiopia, Addis Ababa, Ethiopia. 5. Hamlin Fistula Ethiopia, Mekelle Center, Mek'ele, Ethiopia. 6. Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA. 7. Mekelle University College of Health Sciences, Mek'ele, Ethiopia. 8. University of Oklahoma, Tulsa, Tulsa, OK, USA. 9. Hamlin Fistula USA, San Jose, CA, USA. 10. Oregon Health & Science University, L466, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. 11. Worldwide Fistula Fund, Schaumburg, IL, USA. 12. Washington University, St Louis, St. Louis, MO, USA. 13. Vista Urology and Pelvic Pain Partners, San Jose, CA, USA.
Abstract
OBJECTIVE: Obstetric fistula is a devastating childbirth injury that leaves women incontinent, stigmatized and often isolated from their families and communities. In Ethiopia, although much attention has focused on treating and preventing obstetric fistula, other more prevalent childbirth-related pelvic floor disorders, such as pelvic organ prolapse, non-fistula-related incontinence and post-fistula residual incontinence, remain largely unattended. The lack of international and local attention to addressing devastating pelvic floor disorders is concerning for women in low- and middle-income countries. The objective of this article is to highlight the need for a more comprehsive approach to pelvic floor care and to share our experience in addressing it. METHODS: Here, we share our experience launching one of the first formal training programs in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) in Ethiopia. RESULTS: This fellowship program provides quality care while strengthening the health system in its local context. This program has positioned Ethiopia to be a regional leader by providing comprehensive training of surgeons and allied health professionals, building appropriate health system and research infrastructure, and developing a formal FPMRS training curriculum. CONCLUSION: We hope that sharing this experience will serve as a template for others championing comprehensive pelvic floor care for women in low- and middle-income countries.
OBJECTIVE:Obstetric fistula is a devastating childbirth injury that leaves women incontinent, stigmatized and often isolated from their families and communities. In Ethiopia, although much attention has focused on treating and preventing obstetric fistula, other more prevalent childbirth-related pelvic floor disorders, such as pelvic organ prolapse, non-fistula-related incontinence and post-fistula residual incontinence, remain largely unattended. The lack of international and local attention to addressing devastating pelvic floor disorders is concerning for women in low- and middle-income countries. The objective of this article is to highlight the need for a more comprehsive approach to pelvic floor care and to share our experience in addressing it. METHODS: Here, we share our experience launching one of the first formal training programs in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) in Ethiopia. RESULTS: This fellowship program provides quality care while strengthening the health system in its local context. This program has positioned Ethiopia to be a regional leader by providing comprehensive training of surgeons and allied health professionals, building appropriate health system and research infrastructure, and developing a formal FPMRS training curriculum. CONCLUSION: We hope that sharing this experience will serve as a template for others championing comprehensive pelvic floor care for women in low- and middle-income countries.
Authors: Margaret E Kruk; Anna D Gage; Catherine Arsenault; Keely Jordan; Hannah H Leslie; Sanam Roder-DeWan; Olusoji Adeyi; Pierre Barker; Bernadette Daelmans; Svetlana V Doubova; Mike English; Ezequiel García-Elorrio; Frederico Guanais; Oye Gureje; Lisa R Hirschhorn; Lixin Jiang; Edward Kelley; Ephrem Tekle Lemango; Jerker Liljestrand; Address Malata; Tanya Marchant; Malebona Precious Matsoso; John G Meara; Manoj Mohanan; Youssoupha Ndiaye; Ole F Norheim; K Srinath Reddy; Alexander K Rowe; Joshua A Salomon; Gagan Thapa; Nana A Y Twum-Danso; Muhammad Pate Journal: Lancet Glob Health Date: 2018-09-05 Impact factor: 26.763
Authors: Jerry L Lowder; Chiara Ghetti; Cara Nikolajski; Sallie S Oliphant; Halina M Zyczynski Journal: Am J Obstet Gynecol Date: 2011-02-02 Impact factor: 8.661