What Can HDI Do About Fistula?

Major Support Provided By

Izumi Foundation KavliFondet Norad Provictimis

Introducing an additional approach!

HDI is once again a catalyst at the global level, now to start rapid prevention of obstetric fistula. HDI is introducing tools it has seen and used for 20 years, as a new approach to this major women’s rights, dignity, and health issue.

HDI introduced its Rapid Maternal Mortality and Obstetric Fistula Prevention Program to supplement what others are doing, aiming to spend modest additional amounts and facilitate much faster results. As an initial step, UNFPA, CDC, and HDI got international reproductive health policy agreement on using HDI’s community-based approaches to prevent obstetric fistula. The policy meeting report is available by clicking it, in the resources section of this website.

Then Niger successfully demonstrated that maternal deaths can be rapidly prevented in a large population across a large, remote area, that the health system can be strengthened, and that obstetric fistulas can be prevented using HDI’s Rapid Fistula Prevention approach. The fistula prevention program currently serves more than 263,000 people in an area a bit larger than the American state Delaware.

As of November 2013, only a single program-preventable case of obstetric fistula has occurred during almost 64,000 births in a setting where WHO predicts there would normally be 1 – 2 new obstetric fistulas per thousand births.

And more than 70,000 women have given birth since the most recent maternal death caused by blocked childbirth 5.5 years ago.

Blocked childbirth can be the primary cause of maternal death in remote areas like this.


1.      Expand the project in Niger

UNFPA just started support for one area, and a proposal is being considered (December 2013) that would allow HDI’s approach to be introduced 1,100 kilometers further east. Ultimately, we would like to see this project prevent fistula and maternal deaths nationwide.

2.      Introduce rapid obstetric fistula prevention as large-scale pilot projects in one or more additional countries where maternal mortality and obstetric fistula incidence are unacceptably high

Rapid maternal mortality and prevent obstetric fistula prevention costs about $1/person for a rigorously monitored program in large, remote, difficult-to reach areas.

We estimate that catalyst aspects in more densely populated parts of rural Africa can cost $5 million/year for a multi-country program, well within reach for a consortium of bilateral donors and foundations.

See more at: http://hdi.no/projects/obstetric-fistula

HDI is the only group dedicated to rapid PREVENTION of obstetric fistula.

Information from some who strive to provide treatment is available at:


Updated December 2013