The Role of Universal Health Coverage in the Eradication of Obstetric Fistula in Nigeria—A Commentary

Abstract

Obstetric fistula is a serious public health problem affecting women in low- and middle-income countries. It is characterized by continuous leakage of urine and/or feces from the vagina as a result of injuries sustained from childbirth. It has continued to exist in Nigeria because the publicly funded health-care system has failed to provide quality, equitable, accessible, and affordable maternal health care. It is largely a problem of poor, young, uneducated, and rural women who lack access to quality maternity care. Universal health coverage implies a system which provides quality health-care and financial protection to all citizens of a country. This is attained when all citizens have the needed health services without being subjected to out-of-pocket expenditure. Universal health coverage is currently not obtainable in Nigeria. When implemented, it will eliminate the existing inequality in access to health care, thereby allowing the poor and vulnerable citizens access to quality maternity care and safe delivery. A comprehensive health insurance cover for all pregnant women regardless of socioeconomic status, priority setting in resource allocation, and public–private partnership are advocated for eradication of obstetric fistula in Nigeria.

Women’s views on obstetric fistula risk factors and prevention in north-central Nigeria: an interpretive descriptive study

“…The Nigerian Federal Ministry of Health 15 published a national strategic framework for the elimination of obstetric fistula in Nigeria from 2019 to 2023, as previous strategies did not make any discernible difference: 16 17 Nigeria has established a policy to eliminate obstetric fistula, yet obstetric fistula has continued to exist. 18 The current efforts at addressing this devastating complication of childbirth remain fragmented, uncoordinated and weak at the state level and community levels. 15 15 The Nigerian Federal Ministry of Health's national strategic framework for the elimination of obstetric fistula calls for more strategies that focus on strengthening social systems that empower young girls and provide them with safety nets, 15 however these recommendations almost exclusively represent the views of policy makers and care providers and not those most directly impacted: women themselves, and it has become apparent that there is a need to engage community participation in finding solutions by engaging fistula survivors.…”

“…The Nigerian Federal Ministry of Health 15 published a national strategic framework for the elimination of obstetric fistula in Nigeria from 2019 to 2023, as previous strategies did not make any discernible difference: 16 17 Nigeria has established a policy to eliminate obstetric fistula, yet obstetric fistula has continued to exist. 18 The current efforts at addressing this devastating complication of childbirth remain fragmented, uncoordinated and weak at the state level and community levels. 15 15…”

Journey for a cure: Illness narratives of obstetric fistula survivors in North Central Nigeria

“…biographical disruption, chaos, narrative typology, narratives, obstetric fistula, quest, restitution a human right, the Universal Health Coverage (UHC) mandate of the United Nations stipulates that everyone should have equal access to health care whenever it is required without it causing financial hardship (WHO, 2023). However, in countries where fistula is prevalent, access to quality and affordable health care remains a huge concern (Daniyan et al, 2021). Hence, the commodification of healthcare, which is a violation of the UHC mandate, if not addressed, will hinder the work on eradicating and treating fistula cases.…”