“20 years on – progress but not enough! Act now to end fistula by 2030!”

Obstetric fistula is a hole between the birth canal and bladder or rectum, caused by prolonged, obstructed labour without access to timely, high-quality medical treatment. It leaves women and girls leaking urine, faeces or both, and often leads to chronic medical problems, depression, social isolation and deepening poverty. Ninety percent of pregnancies involving fistula end in stillbirth.

Health systems and communities are falling short in ending obstetric fistula. Gender discrimination and social marginalization create additional risks, resulting in fistula disproportionately occurring among impoverished, underserved and marginalized women and girls.

Three cost-effective solutions can prevent fistula: timely access to high-quality emergency obstetric and newborn care, trained professionals with midwifery skills at childbirth, and universal access to modern contraception. Health systems can reduce fistula by tracking prevalence, correcting gaps in care and ensuring universal access to a competent health workforce. National health plans must also address gender discrimination and other factors making women and girls more vulnerable to maternal mortality and disease.

Bold political leadership and investment could eradicate fistula. Ambitious partnerships and scaled-up investments are imperative to ending fistula by 2030 – our global target under the Sustainable Development Goals.

UNFPA leads the global Campaign to End Fistula, a drive to transform the lives of vulnerable women and girls. The 20-year-old campaign represents a global commitment to fistula prevention and holistic treatment, including surgical repair and social reintegration and rehabilitation. Despite progress, elimination by 2030 demands accelerated action, starting now. To that end, the theme for the international day this year is “20 years on – progress but not enough! Act now to end fistula by 2030!”

Ending obstetric fistula by 2030

2020 marked the count-down towards the goal of ending the problem of obstetric fistula by 2030, according to the last report of the Secretary General.

Obstetric fistula is preventable; it can largely be avoided by delaying the age of first pregnancy; the cessation of harmful traditional practices; and timely access to obstetric care.

Besides, it is expected that 13 million more child marriages could take place by 2030 than would have otherwise. Families are more likely to marry off daughters to alleviate the perceived burden of caring for them, especially in the anticipated economic fallout of the pandemic.

Due to all these reasons an increase in cases might occur and new strategies will be required in the post-COVID-19 recovery period to address the expected backlog of cases.

With this possible future scenario of preventive measures in danger, now more than ever, it is important to call on the international community to use the International Day to End Obstetric Fistula to significantly raise awareness and intensify actions towards ending obstetric fistula, as well as urging post-surgery follow-up and tracking of fistula patients.

UNFPA leads the global Campaign to End Fistula, a drive to transform the lives of vulnerable women and girls.

The 20-year-old campaign represents a global commitment to fistula prevention and holistic treatment, including surgical repair and social reintegration and rehabilitation. Despite progress, elimination by 2030 demands accelerated action, starting now.