Preventing and Rehabilitating Obstetric and Surgical Fistula through Gender-Responsive Reproductive Health Education and Strengthened Services (PROGRESS)
Situation:
Bangladesh has made progress in maternal health: maternal mortality declined to 115 per 100,000 births (2023). Fistula prevalence fell from 1.69 to 0.49 per 1,000 women, with around 1,000 new cases annually. In 2023, 52.1% of cases were obstetric and 43.2% iatrogenic. Yet only about 1 in 50 affected women seek treatment. Key barriers include limited access to information and care, shortages of skilled health workers, rising caesarean section rates, and disparities between urban and rural areas.
Objectives:
Overall Goal: Fistula survivors and women of reproductive age in Rajshahi District experience improved health, dignity, and quality of life through strengthened health system capacity to prevent, identify, and treat fistula, and enhanced access to quality maternal, newborn and child health services (MNCH) and Sexual and Reproductive Health and Rights (SRHR) services.
- Percentage of of women, youth and children who received treatment and rehabilitation support with improved quality of life (disaggregated by gender and age groups -15, 15-24, 24+ years)
- Number of persons in need of specialised healthcare referred (disaggregated by type of case, level of referral, gender, age groups -15, 15-24, 24+ years)
- Percentage of successful repairs (at discharge)
The project trains healthcare providers in fistula prevention, strengthens early detection, and promotes safe referrals. It improves surgical care and follow-up for fistula survivors, reduces drop-out rates, and supports reintegration. In addition, it strengthens maternal and child health services through training, equipment, and improved service delivery.
The project embeds activities in the public health system, strengthens health workers, and improves referral pathways for continuum of care. It promotes collaboration with government authorities, community engagement, and socio-economic reintegration of fistula survivors while reinforcing sustainable partnerships and local capacities.
The project is based on a holistic approach. To achieve its goal, it focuses on three key domains: (1) awareness and prevention, (2) referral, diagnosis, and treatment, and (3) SRHR as well as MNCH services.
