The persistence of obstetric fistula-a devastating childbirth injury occurring largely among poor, marginalized women and girls-constitutes a human rights violation and a public health crisis. The Sustainable Development Goals (SDGs) aim to "leave no one behind." Failing to eliminate fistula jeopardizes attainment of several of the SDGs.Member States of the United Nations adopted a UN Resolution on ending fistula in 2018, calling for an end to fistula within a decade. Building upon recommendations of the UN Secretary General's 2018 Report on Obstetric Fistula, the Resolution calls for significantly increased commitments and investments to end fistula. Crucial interventions for eliminating fistula include high-quality, equitable, accessible health systems; implementing costed national strategies for eliminating fistula; integrating fistula into national plans to achieve the SDGs; strengthening national fistula task forces; and significantly increased, sustained financial support. Fistula elimination necessitates protecting women's/girls' human rights and addressing social determinants that affect women's/girls' ability to "survive, thrive and transform," including social and economic inequities; gender-based violence; child marriage and early childbearing; and access to education. Enhanced awareness-raising and advocacy; improved research, data, monitoring and evaluation; holistic social reintegration and survivor empowerment; and community engagement are additional key strategies for realizing this ambitious goal.
Aims: To provide a global overview on progress, successes, challenges/lessons learned, and the way forward towards the UN global vision of ending fistula within a generation. Methods: This interactive presentation will feature highlights of the 2018 United Nations Secretary-General's report on "Intensifying efforts to end obstetric fistula within a generation" and the subsequent United Nations General Assembly Resolution A/RES/71/169. Results: Key elements in the Report include linking the call to end fistula within a generation with the achievement of the Sustainable Development Goals (SDGs); integrating fistula with global efforts to achieve universal access to emergency/essential surgery; addressing root causes of fistula; and calling for UNFPA/Campaign to End Fistula to lead development of a new global road map to end fistula within a generation. Conclusions: To succeed in ending fistula within a generation, we must galvanize momentum and mobilize the international community to invest and act upon key recommendations of the 2018 Secretary General’s Report on fistula. These include: strengthening health systems; implementing and monitoring cost national strategies for eliminating fistula; including fistula into national SDGs implementation plans; strengthening national task forces for fistula; securing significantly increased, predictable, sustained, and adequate financial support; strengthening awareness-raising and advocacy; and improving research, data collection, monitoring and evaluation to end fistula and make the “invisible”, visible.
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