MORE ON Obstetric Fistula 
Introducing an additional approach!
HDI is proving to be a catalyst at the global level, as it has been before, now to help get the ball rolling towards eliminating obstetric fistula. HDI is introducing tools it has seen and used for 20 years, as a new way to approach this important women’s rights, dignity, and health issue, not to replace but as an addition to what else is going on, to spend relatively modest additional amounts and get faster results. As an initial result, UNFPA, CDC, and HDI got international reproductive health policy agreement on using disease eradication approaches to prevent obstetric fistula. The policy meeting report is available by clicking it, on the front page of this website, as well as from several places on UNFPA websites. Then Niger successfully demonstrate that maternal deaths can be rapidly prevented in a large population across a large, remote area, that process indicators including the number of births occurring in the health system can be improved, and that obstetric fistulas can be prevented using the HDI-RFP (Rapid Fistula Prevention) approach.
Next Steps
Having achieved two important successes, there are two next steps: Expand the pilot project to demonstrate success in an even larger area. Funding proposals are being considered (November 2009) which would allow testing this approach in even larger areas that are not contiguous, to serve a multiethnic population of over 262.000 people across more than 7.500 square kilometers. Introduce other agencies and countries to the idea of rapidly preventing maternal mortality and obstetric fistula. At The Carter Center in Atlanta, USA early in 2010, fifty representatives of UN agencies, important foundations, governmental development assistance agencies, NGOs (non-governmental organizations), and universities will consider the evidence on various approaches to rapidly prevent obstetric fistula.
Cost
It is estimated that all catalyst functions for a 12-country program eradicating guinea worm disease amount to around $2 million/year for the continent of Africa. We estimate that catalyst aspects for a similar effort to rapidly reduce maternal mortality and prevent obstetric fistula would cost $5 million/year, well within reach for a consortium of bilateral donors and foundations. (Updated November 2009)