RESUMEN
Obstetric fistula is treatable by surgery, although access is usually limited, particularly in the context of conflict. This study examines the profile of women attending fistula repair surgery in three hospitals in Somalia. A cross-sectional study was conducted in Somalia from August to September 2016. Structured questionnaires were administered to 81 women who registered for fistula repair surgery in the Garowe, Daynile, and Kismayo General Hospitals in Somalia. Findings revealed that 70.4% of the study participants reported obstetric labor as the cause of their fistula, and 29.6% reported iatrogenic causes. Regarding the waiting time for the repair surgery, 45% waited for the surgery for over one year, while the rest received the surgery within a year. The study suggests that training for fistula surgery has to be provided for healthcare professionals in Somalia, fistula centers should be established, and access to these facilities has to be guaranteed for all patients who need these services.
RESUMEN
The 1994 International Conference on Population and Development represented a paradigm shift from vertical population control programmes to the broad-based promotion of sexual and reproductive health as human rights, through strengthening of health services and dealing with the underlying social determinants of health. In its Programme of Action, the global community set ambitious targets for reproductive health, based on strong political will among senior politicians and supported by many grassroots NGOs. Today, too little progress has been made, and the targets are not expected to be met. One of the reasons why may be that support for the reproductive health agenda has been de-politicised, with a focus on management and technical issues instead of unleashing the power necessary for change. Two other contributory trends, affecting more than reproductive health are discussed. Firstly, there has been a call for measurable goals and the use of indicators as a basis for planning, instead of valid and reliable measures for monitoring complex processes. This has led to a new form of vertical programme in reproductive health, in which the comprehensive nature of reproductive health has been left out, and a narrow definition of maternal health has been singled out for attention. Secondly, instead of nurturing the different roles of different actors in the struggle to achieve better reproductive health, the focus has been on coordination and harmonisation, which are not appropriate for dealing with controversial issues.
Asunto(s)
Objetivos , Salud Reproductiva , Femenino , Política de Salud , Humanos , Internacionalidad , Masculino , Servicios de Salud Materna , Mortalidad Materna , Defensa del Paciente , Política , Indicadores de Calidad de la Atención de SaludAsunto(s)
Salud Global , Objetivos , Medicina Reproductiva , Derechos Humanos , Humanos , Factores Socioeconómicos , Naciones UnidasRESUMEN
Norway has a long history of good reproductive health care, with some of the world's best reproductive health indicators. Early reduction of maternal mortality, good services for abortion, contraception and sexually transmitted diseases, a low rate of adolescent pregnancies and a low number people with HIV are examples, achieved through an integrated, publicly provided and funded health care package. Official Norwegian development assistance started in 1952. Emphasis on family planning assistance dates back to 1966, making Norway one of the most consistent donors to family planning and reproductive health programmes. Norway also had a high profile at the International Conference on Population and Development and strongly supported the Programme of Action. Since then, while multilateral support in these areas has stayed high, bilateral support has been downscaled. Overall, international assistance does not reflect the domestic approach to reproductive health services. Norway has given little development support to improvement of maternity services, avoided the issues of abortion and post-coital contraception, and passed up opportunities to support adolescent services. Prevention and treatment of infertility has hardly been an issue. Revitalisation of the reproductive rights discourse in Norway could provide a basis for the protection of reproductive health care domestically, and for policy discussions and decisions in relation to Norway's development assistance.