By Sarah Tumwebaze & Agatha Ayebazibwe

Lack of access to skilled birth attendants is the major cause of fistula in Uganda, health experts have said. The commissioner clinical services, Dr Jacinto Amandua, said women get complications such as fistula because they lack skilled medical intervention during child birth.

“Out of every 100 women that give birth, 15 per cent of them need help that will require a skilled medical personnel but because the experts are rarely available, this explains why some women end up with conditions like fistula,” Dr Amandua said yesterday in Kampala during the launch of a report on fistula.

Fistula is an injury that occurs during childbirth, usually when a woman is in labour for too long or when delivery is obstructed. It causes an abnormal opening of the birth canal resulting into the continuous leakage of urine and stool leaving the woman with a persistent odour.

Dr Jane Aceng, the director general of health services, said fistula is one of the most devastating consequences of difficult labour to a mother. While Dr Aceng confirmed that fistula represents an important public health problem in Uganda, she added that the actual prevalence of this condition remains unknown.

High prevalence
Currently, the prevalence is based on a 2006 Uganda Demographic Health Survey which shows that 2.64 per cent (200,000) of Ugandan women have ever suffered from symptoms of fistula, while 1,900 new cases are registered yearly.

Speaking at the same event, Ms Edith Ronah Mukisa, the country manager of EngenderHealth, said another cause of fistula are delays. “Delay at home, delay to get to the health centre and delayed intervention while in hospital,” she said.

The report that is based on a four-year study revealed that transport was also a challenge to women in labour, forcing them to give birth from home with no medical personnel to attend to them.

Dr Amandua said although government has trained experts to attend to pregnant women, providing family planning services and bringing health centers closer to people, government needs to mitigate the magnitude of fistula in Uganda. “This will help sort the challenges of planning, budgeting and service delivery,” he said.

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