DRAFT TEMPLATE FOR RESULTS FRAMEWORK FOR CAMPAIGN TO END FISTULA
I. Treatment GOAL: Reduce the prevalence of obstetric fistula
Prevalence rate to be based on estimated incidence of fistula and duration (suggested method of calculation for incidence 2 to 5 cases of fistula per
1000 women surviving after complicated delivery1) - WHO will look at models for calculating
Objectives/Strategies
General Objective: To ensure all
women with obstetric fistula
have access to high quality
treatment services
Outcomes/Outputs
Outcome: All women with
Obstetric Fistula have access to
high quality treatment services
Obj 1. To establish sustainable
national policies and plans
including resource allocation for
OF treatment
Strategies
1.1 To assess the national situation
regarding obstetric fistula
Outcome: Sustainable national
policy and plan for OF treatment,
including resource allocation,
developed
Outputs:
National needs assessment
conducted
1.2 To establish a multi sectoral
taskforce to develop and oversee
the national plan and mobilize
resources
1.3 To ensure financial resources
are available to subsidize fistula
treatment
Multi-sectoral task forced created
and functioning to develop,
oversee and mobilize resources for
the national plan
Budget allocation developed
Obj 2. To strengthen health
systems capacity to provide
accessible high quality OF
treatment
Outcome: Health system provides
high quality OF treatment services
1
2
OF data included in routine HMIS
data collection
Indicators
% of women with
fistula treated annually
(use estimated
incidence calculation
above)
-Validated plan (by end
of 2006)2
-Resources raised and
allocated to plan
MoV
Risks/Assumptions
Project document
Political commitment,
partners engaged, nat’l
ownership, availability of
resources
-Nat’l NA conducted,
endorsed and published
(by end of 2005)
-Group established and
met at least once (by
end 2005)
Project document
Assessment is of high
quality
Report/minutes of
meetings
Note de service
Partners engaged,
coordination exists,
political commitment
Budget allocated
Project document
includes budget,
recipients and
mechanism for
distribution
Treatment centre
records, National
statistics
Financial Resources
available, partners engaged,
political commitment
-% of patients treated
annually out of
estimated incidence
(see above, suggested
100%)
-% of patients
successfully3 treated
Total population plus expected births per 100,000 (b/w 4 and 5,000) minus maternal deaths
Discussion regarding whether to set time limits, is this imposing on countries/taking away from ownership
Quality of records at the
centre, women don’t return
for follow-up, assumption
that all centres advise
women to return for followup, patients follow
instructions
(suggested 85%)
-% of patients treated
successfully with
continence after 6
months on annual
basis4 (suggested 90%
of the 85%)
Strategies
2.1 To establish at least one high
quality functional fistula center per
country
Outputs:
At least one high quality fistula
treatment centre established and
functioning per country
2.2 To ensure at least 2 trainers in
obstetric fistula treatment per
country
Each country has at least 2 trainers
in obstetric fistula treatment
2.3 To establish a functional
referral system for obstetric fistula
treatment
Referral system for obstetric
fistula treatment established and
functioning
2.4. To have functional recording
and reporting system for data for
obstetric fistula treatment services
Recording and reporting system
for obstetric fistula treatment
services established and
functioning
3
Fistula is closed surgically.
90% of successful closures are also continent, 10% are still incontinent
5
Dealing with all types of fistula cases
6
definition of trainer to be added
4
-# high quality
treatment centres5
capable of dealing with
all types of fistula
successfully established
(minimum at least one)
-Same indicators as
above per centre to
determine ‘success’
-# of trainers6 in
obstetric fistula
management (minimum
expected is 2)
-Proportion of patients
referred who reach
treatment centre
-Proportion of women
treated returning with
feedback information
-Records, registers and
reports completed for
each treatment centre
-Data analysed and
used for center-specific
and national plan
monitoring and
Treatment centre
records, MOH records
Each centre has a reliable
recording and reporting
system, flow of data from
centres to the central level
exists.
MOH records, trainer
CVs
Brain drain, motivation
exists
District reporting +
centre reporting, NGO
records
Referral is documented,
accurate records,
infrastructure in place for
referral, providers trained to
make appropriate referral
Records and registers at Task force is in place,
the treatment centres,
Reports at MOH,
national plan
evaluation documents
2.5 To establish and implement a
national training curricula
National training curricula
established and implemented
2.6 To establish a functional
national monitoring system for
obstetric fistula treatment services
National monitoring system for
obstetric fistula treatment services
established and functioning
2.7 To establish a mechanism for
ensuring financial accessibility of
treatment
Mechanism for ensuring financial
accessibility of OF treatment
services established and
functioning
Outcome: Community supports
women with fistula to access
treatment
Obj 3 To strengthen community
capacity to support women with
fistula to access treatment
Strategies
3.1 To ensure community
awareness that obstetric fistula is
treatable and of where treatment is
available
3.2 To ensure community
involvement in supporting women
with fistula to access treatment
Outputs: Community members
know that obstetric fistula is
treatable and where to access
treatment services
Community members actively
involved in supporting women
with fistula to access treatment
evalution
-National training
curriculum developed
-% of training
institutions using the
curriculum
-# of health
professionals trained
with the curriculum
-Monitoring
mechanisms
established at all levels
-% of planned
supervisory visits that
take place
-% of planned
monitoring reports
submitted
Curriculum document
printed, training
institution
reports/records
Monitoring reports,
Supervision reports
Trainers available, trainers
use curriculum