Table 3 Facilitators to interventions aimed at the prevention of obstetric fistulas, categorised by the three phases of delay
Phase one: Decision to seek care | Phase two: Reaching a facility or preventive intervention | Phase three: Receiving adequate care through a preventive intervention |
|---|---|---|
• Women with successful treatments acting as ambassadors and advocates for healthcare facilities  ○ Women are provided with training on public speaking and interpersonal communication skills • Increased awareness within communities through training  ○ About maternal/ child morbidities, and the importance of seeking care • Community involvement  ○ Volunteer coordinator provides SMAGs with technical support, and schedule activities and training  ○ Increased involvement of men, community leaders, and religious leaders, as they are decision-makers within these communities • Financial support  ○ Allowing women to participate in income-generating activities  ○ Free healthcare services for pregnant women and children under 5 years old | • Financial support  ○ Reimbursement for transport  ○ Insurance plan that provides transport costs  ○ Community generating money to assist with transport costs • Assistance with transport  ○ A politician procured an ambulance, which facilitated the evacuation of labouring women in need  ○ All-terrain motorbikes to facilitate transport to healthcare facilities • Volunteers initiate evacuation by phoning a midwife at a facility that has an ambulance available • Volunteers arrange transport to the closest facility • Relocation of midwives in rural areas where the most at-risk women and girls reside • Improved mobile coverage to arrange evacuation | • Mobilisation of recognised experts • Training  ○ On the local needs as a means of improving the morale for the provision of preventive care  ○ On the improved use of the partograph  ○ Of patients so they educate women and their local communities when they return home • Financial support from international foundations and organisations  ○ Insurance plan that covers medical costs for pregnant women • Partnerships that provide funds for research, the purchase of essential equipment, and the development of basic infrastructure  ○ Donation of supplies and volunteers’ time, which improves adequate staffing, space, equipment, and essential medication • Employment of more midwives • Mobile prenatal clinics serve remote villages |