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Prevention and Treatment of Obstetric Fistula: Identifying Research Needs and Public Health Priorities

CO-SPONSORED BY:
WHO - UNFPA - FIGO
July 28-30, 2005

Johns Hopkins Bloomberg School of Public Health
Feinstone Hall
Baltimore, Maryland

Meeting objectives:

  • to advance scientific knowledge on the risk and treatment of obstetric fistula
  • to prioritize research questions regarding public health and clinical responses to obstetric fistula
  • to inform the design of a study addressing one or more key research needs
  • to inform the public health response to and management of obstetric fistula


TimeTopicSpeaker

Thursday, July 28

Chair, Rene Genadry, Johns Hopkins School of Medicine, Department of Gynecology and Obstetrics

8:30-9:00a

Welcome
Meeting Objectives
Introductions

Co-Sponsors
Amy Tsui, Gates Institute

 Invited PlenaryBlank
9:00-9:45a

An agenda for epidemiologic research and clinical management of obstetric fistula
Discussion

John Kelly, Women's Hospital, Birmingham

9:45-10:30a

The global campaign to end fistula: What have we learned?
Discussion

Katie Tell, UNFPA/New York
Edwige Adekambi Domingo, UNFPA/Benin

EPIDEMIOLOGY OF OBSTETRIC FISTULA

11:00-11:30a

What we know and don't know about obstetric fistula: a review of current knowledge
Discussion

Saifuddin Ahmed and Sara Holtz, JHSPH

11:30-12:00

Challenges of global estimation of obstetric fistula
Discussion

Cindy Stanton, JHSPH

CLINICAL MANAGEMENT

Chair, Andre Lalonde, FIGO

 Clinical review of obstetric fistulas 

1:00-1:45p

Simple and complex fistulas and complications of fistula surgery
Discussion

Rene Genadry, JHMI, and Andreea Creanga, JHSPH

 Simple fistulas 

2:00-2:15p

2:15-2:30p
2:30-2:45p
2:45-3:00p

Evaluation and classification

Low technology approach
Pre- and post-operative care

Discussion

Marcella Roenneburg, Mercy Hospital
AT Lassey, University of Ghana

 Complex fistulas 

3:15-3:30p
3:30-4:00p


4:00-4:15p

Surgical techniques
Selection criteria for VVF Surgery
Follow-up of the diverted VVF Patient
Discussion

C. Robert Wheeless, JHMI
Steve Arrowsmith    , Mercy Ship/World Fistula Fund

 Complications of treatment 

4:15-4:30p
4:30-4:45p
4:45-5:00p
5:00-5:15p

Gynatresia
Incontinence after fistula closure
Complications of diversion
Discussion

C. Robert Wheeless, JHMI
Jacek Mostwin, JHMI
Jennifer Dodson, JHMI

5:15-5:45p

Communique deliberations
Adjournment

 

6:15p

Dinner Keynote: Ethical Issues in Fistula Care and Research

Lewis Wall, Washington University


Friday, July 29


Chair, Mary Ellen Stanton, USAID

HEALTH SYSTEM RESPONSE AND PUBLIC HEALTH PRIORITIES

8:30-9:15a

Providing services through special fistula hospitals versus decentralized services at local hospitals: Advantages and disadvantages
Discussion

Lewis Wall, Washington University

 

Burden of VVF: Case Studies

 

9:15-9:45a

Oladosu Ojengbede, University of Ibadan
Oladapo Shittu, Ahmadu Bello University

9:45-10:15a

Obstetric Fistula in Niger



Ghaichatou Amoulkinni, International Organization for Women and Development

Abdoulaye Idrissa, National Hospital of Niamey

10:30-11:30a

Trends in fistula admissions at two teaching hospitals in Ghana




George Klufio, Korle Bu Teaching Hospital, University of Ghana*


K.A. Danso, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology

11:30a-12:00p

Hailegiorgis Aytenfisu, Ethiopian Society of Obstetrician and Gynecologists

12:00n-1:00p

Lunch: Preview of documentary "A Walk to Beautiful" about Addis Ababa Fistula Hospital.

Engel Brothers Media

*Dr. Klufio was unable to attend, Dr. A Lassey will present in his place.

1:00-1:55p

Concurrent Group Sessions (A)

Facilitation

 
  1. Clinical definition and classification
  2. Protocols for diversion
  3. Incontinence management

Lewis Wall / Marcy Roenneburg, JHMI
Yegappan Lakshmanan / Rob Gutman, JHMI
Jacek Mostwin, JHMI

2:05-3:00p

Concurrent GroupSessions (B)

 
 
  1. Improving community knowledge of prevention and treatment of fistula
  2. Social re-integration of fistula patients
  3. Building public health-clinical partnerships to address obstetric fistula problems

Mary Nell Wegner, EngenderHealth


Rahmat Mohammed, FORWARD, Nigeria

Kokila Agarwal, JHPIEGO


Chair, Katie Tell, UNFPA

PANEL ON PREVENTION RESEARCH

3:15-3:40p

Maternal nutrition and the risk of obstetric fistula and other maternal morbidities

David Rush, Tufts University

3:40-4:00p

The role of delayed childbearing and obstetric care interventions in the prevention of obstetric fistula

Amy Tsui, JHSPH

4:00-4:20p

Using Research with Women and Providers to Shape Public Health Priorities

Maggie Bangser, Women's Dignity Project

4:20-4:45p

Discussion

 

CONCLUDING STEPS

4:45-5:30p

Communique on Prevention and Management of Obstetric Fistula

Facilitated by JHU team

5:30p

Closing Comments

Adjourn

 


Saturday, July 30 (E9519)


Chair, Amy Tsui, Gates Institute

SPECIAL WORK SESSION ON RESEARCH AGENDA

8:30-9:00a

Review of Meeting: Identified Public Health and Clinical Research Priorities

Saifuddin Ahmed
Rene Genadry

9:00-9:30a

Research Priorities of Sponsor Organizations

  • UNFPA
  • WHO
  • FIGO




Katie Tell

Maggie Bangser
Andre Lalonde

9:30-10:30a

Country-Defined Research Priorities and Needs

  • Ethiopia
  • Ghana
  • Malawi
  • Niger
  • Nigeria

Country representatives

10:45-11:15a

Outline of a Multi-Country Research Plan

Saifuddin Ahmed
Cynthia Stanton

11:15a-12:15p

Discussion

 

12:15-12:45p

Next Steps

Closing Comments

Amy Tsui

 

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