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IOFWG meeting Maputo, 10-12 Oct 2011

IOFWG meeting Maputo, 10-12 Oct 2011. Re-caps Day 1 and 2 Luc de Bernis. Day 1. IOFWG. Partnership (50 countries, 60 partners) Prevention, treatment, social reintegration Decision body of the Campaign to Eradicate OF 5 sub-WG. Mozambique.

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IOFWG meeting Maputo, 10-12 Oct 2011

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  1. IOFWG meeting Maputo, 10-12 Oct 2011 Re-caps Day 1 and 2 Luc de Bernis

  2. Day 1

  3. IOFWG • Partnership (50 countries, 60 partners) • Prevention, treatment, social reintegration • Decision body of the Campaign to Eradicate OF • 5 sub-WG

  4. Mozambique • P. Guzman, UNFPA Rep: national Campaign, increasing number of women treated, advocacy, social reintegration. Challenges in data collection. Needs for research • Deputy MoH: MMR>500. Girls and women protection. Quality services provision. Age at marriage, FP • Dr. Aldo Marchesini (Moz.) Reminder of surgeons working in complete isolation Hand-on training, camps followed with mentorship

  5. Campaign(Gillian Slinger) • 2003 • 12  50 countries • Number of treatments?? • Social Reintegration: in 24 countries working with Fistula Advocates • UN resolution in Nov 2010. UNSG Report 2010 • Launch of training manual (FIGO, ISoFS & partners) • Training strategy • CHALLENGES

  6. Communication(Etienne Franca) “We always try to remove the barriers and make sure we make impact” Make visible what happen in the field Improving field work with better communication Participation Lessons learned www.endfistula.org International and national journalists

  7. Holistic approach for complex human condition Addis Fistula Hospital - Center of excellence, setting standards, laboratory for innovations • 1959-2011 Satellites (access) • Closing 93% closure and continence at first attempt, 82% GREAT but not enough!! • Pre-surgery treatment and support (nutrition, TB, …) • Culturally acceptability and Quality of life - Blankets, Coffee ceremony, literacy, languages, … • Physiotherapy • Education and training • Job opportunities (surgeon, aid nurse, physiotherapy, …) • Desta Mender • Midwifery school: developing midwives as leaders; selected with the community; placement (orchestration++); financial net. First successes, to be documented (500 childbirth). Career path, girl empowerment ++ • Research

  8. Working at community level – voices of survivors Musa Isa, Kano, Nigeria, 180 incurable women One by One, Sarah Omega, Western Kenya • Fistula survivors + other women + men!! Identification, counseling, transportation, follow-up ++ and support

  9. Incurable • Definition of success, patient perception • Who can decide? • Social reintegration/empowerment, self-estime + safety net: hostel, half way home • Follow-up: retreat, mobile phone

  10. ISOFS(Tom Raasen) 2007 2008, 09, 10 meetings Not yet registered On line journal. w.ww.isofs.org FIGO-ISOFS OF Surgery CB Training manual – Log Book, 2 classification Workshops Training strategy

  11. Training strategy • Master Trainers identification • Training centers identification • Workshops (using CBT Manual) • 6-8 weeks of training (in recognized high level standard training centers) + mentoring • Sponsorships • Harmonisation of the medical files/data collection • National and sub-regional strategies • Accreditation

  12. Day 2

  13. Working at Community level Healing hands of Joy, Tigray, Ethiopia To empower women living with OF  Advocates One month training Community training and HEWs M&E ++ Transportation - MWH

  14. Country Programmes • Mozambique, Igor Diaz • Liberia, John Mulbah • Pakistan, LauryRomanzi (IUGA) • Asia, Vinit

  15. Mozambique • 20 M, 58% below poverty line, 75% rural • MMR 408, 2003 [550 (UN, 2010), 25% HIV, Progress] • SBA 48.6% (2006), CPR 17% (2003) • 5 years Government plan, New Task Force • Treatment: 2011, 210 cases, 92% success • Central hospital + Campaigns (training) • Technicos de surgeria • Communities • Acceleration?

  16. Liberia • 4.1M, MMR 990 (2008) very slow progress • 3 OG, 412 midwives • Survey 2007  National plan  4 pilars • Advocacy: Media, journalists, survivors, schools • Treatment: 190 cases per year, 83% success • Training: 1 team to Nigeria, 1 Center for excellence • Rehabilitation/social reintegration and tracking (30-40% budget) Ownership, Political commitment, Mobilisation, Partnerships, South-South, Communication, Free of charge

  17. Pakistan • 170 M • 5000-8000 new cases per year • 7 Regional Centres: 2006-08: 1.170 repairs, 390 cases/year 2009-10: 1.030 repairs, 440 cases/year • Referral Centres (reference)

  18. Asia • Mismanagement and Programmatic failure • Prevention, treatment and social reintegration • Data: continuous data collection for guiding action • Health systems. Community awareness, Professionals, Private sector • Conceptual Framework • Afghanistan, Bangladesh, Cambodia, Laos, Myanmar, Nepal, Pakistan, Timor Leste • Mobile phone

  19. Research - JHU • Complexity, Pre and post operative quality of life • Observational longitudinal survey • Socio-economic characteristics • Clinical description  treatment: successes and risks for failure (severe scarring) • Social support, counseling, reintegration and follow-up • Multicentric • Classification • Validated Tool to assess QoL ++ • Funding

  20. Country programmes: targets/year, budget • How to accelerate increasing number of women treated? Performance-based financing? Quality • How to improve prevention? Research • How to improve social-reintegration? Budgets, Advocacy

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