99% of maternal deaths occur in developing countries, and the probability that a young woman dies in childbirth or during pregnancy is 1 in 54, as opposed to 1 in 4900 in developed countries (WHO, 2015). Reducing this gap is a target outlined by Sustainable Development Goal 3, which aims to reduce maternal mortality ratio around the world to less than 70 per 100, 000 live births by 2030.
WAHA International places women’s health and particularly maternal health at the heart of its activities. Due to socio-cultural factors such as poverty, financial dependence, lack of education, violence or conflict, women and girls often have more difficulty than men in accessing quality healthcare. They are also exposed to significant risks including HIV, breast cancer, genital mutilation, and complications during childbirth.
Addressing the reproductive health concerns of women and mothers is of utmost priority for WAHA. Our reproductive health projects focus on ensuring a continuum of care for women throughout pregnancy, childbirth and in the postpartum period. We strongly promote skilled attendance at delivery in health facilities and high quality postpartum care including access to family planning and obstetric fistula treatment services.
Largely, our projects aim to address in a comprehensive way the health needs of women from family planning and reproductive health, to accessing antenatal care and birth attendants, to post-partum care. WAHA addresses the “Three Delays” in order to improve maternal health outcomes:
- Delay in the decision to seek care
- Delay in reaching a health care facility
- Delay in receiving adequate care.
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Our interventions include capacity building and community mobilization through information, education and communication (IEC) activities, implementation and strengthening of referral systems. Additionally, we focus on structural improvements to health facilities, provision of supplies and equipment, training and provision of health workers including midwives and clinicians in obstetric care, development of policies to retain health workers, and research around new and innovative service delivery strategies. The goal of our actions is to ensure maternal and child survival and avoid preventable illnesses during the critical phases of pregnancy, labour, birth, and the postnatal period.
We provide mobile antenatal care to ensure that mothers are vaccinated, tested for sexually-transmitted infections, have an adequate nutritional status, provided preventative therapy for malaria and screened for non-communicable disease such as diabetes. All these actions improve maternal and child health outcomes.
Obstetric fistula is a birth delivery complication, when a lack of blood supply to the tissue leads to a hole between the birthing canal and the bladder and/or the rectum. This causes the leaking of urine and/or faeces, and can cause chronic medical problems. Although there are increasing efforts to reduce the number of cases, there are still 50 000 to 100 000 women who suffer from obstetric fistula each year (WHO, 2014). These women, often young, are excluded from their communities.
Obstetric fistulas are often caused by prolonged, obstructed labour, unsafe abortions, surgical trauma, and rarely as a result of rape or sexual abuse. Early childbirth can also contribute to increased birth complications and the development of obstetric fistulas, especially in contexts where health services are poor or inaccessible.
For the rare inoperable cases of fistula or recurrent fistula following unsuccessful repair, WAHA brings together advanced expertise and an innovative strategy in the form of a prosthesis. The initial clinical trial of the prosthetic device shows promising results.
Since 2003, there has been a significant global effort to address the burden of obstetric fistulas through the Campaign to End Fistula. As a leading partner, WAHA International has a comprehensive strategy to address fistula that include prevention, surgical treatment and social reintegration. Obstetric fistulas affect women in developing countries, where access to maternal care is limited or non-existent. Therefore, WAHA targets hard-to-reach populations using innovative mobile approaches including mobile clinics and medical teams travelling to remote areas.
Obstetric fistulas are preventable and curable. Early diagnosis by healthcare providers and midwives are an important effort to mitigate the occurrence of obstetric fistulas. WAHA works to mobilize communities to address childbirth and reproductive rights challenges. Populations are educated on maternal health risks and needs, as well as informed on existing treatment options and when to seek medical care. Preventative efforts also focus on increasing the number of births attended by a midwife or a skilled medical professional as well as improving health facility infrastructure to include more delivery rooms and the appropriate equipment and supplies to carry out caesarean section when necessary.
Obstetric fistulas are treatable. Once an obstetric fistula occurs, it requires surgical repair as it rarely heals by itself. According to the WHO, over 90% of women who experience obstetric fistulas can be cured with an operation and can continue livingdignified and active lives, including having other children. WAHA’s specialists are committed to training local health professionals and manage affordable permanent or temporary centres to treat obstetric fistulas in several countries.Furthermore, WAHA supports the social re-integration of women who have suffered from obstetric fistulas through a variety of skill-building re-integration activities including creating artisanal crafts.
Pelvic organ prolapse (POP) is a result of weakening of the pelvic floor muscles and fascias causing organs to prolapse outward and giving a sag or bulge down into the vagina.
The main cause of vaginal prolapse is childbirth and birth trauma and other causes include heavy lifting, chronic coughing, or constipation and old age. The symptoms of POP can significantly impact the daily activities, sexual function and physical exercise. A woman’s lifetime risk for POP surgery is between 12-19% and recently, prevalence has increased among elderly women (BMJ, 2016).
WAHA trains health care specialists on how to conduct vaginal prolapse surgery, bringing in experts to remote communities and supporting the training of local doctors.
When urinary and faecal incontinence occur in young females, it is often caused by trauma to the pelvic floor muscles and fascias related to prolonged, obstructed labour. There is little data on the prevalence of incontinence in resource-poor countries, however there is an increased risk in areas where there is high fertility rates and limited maternal health care.
WAHA provides treatment for incontinence and training for local practitioners in performing care.