A/RES/73/147
Intensification of efforts to end obstetric fistula
gynaecologists and doctors, and providing support for the development and
maintenance of infrastructure, as well as investments in referral mechanisms,
equipment and supply chains, to improve maternal and newborn health -care services
and ensure that women and girls have access to the full continuum of care, with
functional quality control and monitoring mechanisms in place for all areas of service
delivery;
(c) Supporting the training of doctors and surgeons, nurses and other health care workers in life-saving obstetric care, especially midwives, who are the front-line
workers in the fight to prevent obstetric fistula and maternal and newborn mortality,
including training on fistula prevention, treatment and care as a standard element of
the training curricula of health professionals;
(d) Ensuring universal access through national policies, plans and
programmes that make maternal and newborn health-care services, particularly
family planning, skilled attendance at birth, emergency obstetric and newborn care
and obstetric fistula treatment, financially accessible and affordable, including in
rural and remote areas and among the poorest women and girls through, where
appropriate, the establishment and distribution of health-care facilities and trained
medical personnel, collaboration with the transport sector for affordable transport
options, support for developing and maintaining infrastructure to improve maternal
and newborn health-care services and to strengthen the capacity for surgery, the
promotion of and support for community-based solutions and the provision of
incentives and other means to secure the presence in rural and remote areas of
qualified health-care professionals who are able to perform interventions to prevent
obstetric fistula;
(e) Developing, implementing, following up on and supporting national and
international prevention, care and treatment and socioeconomic reintegration and
support strategies, policies and plans to eliminate obstetric fistula within a decade by
developing further multisectoral, multidisciplinary, co mprehensive and integrated
action plans in order to bring about lasting solutions and put an end to maternal
mortality and morbidity and obstetric fistula, which is preventable and treatable,
including by ensuring access to affordable, accessible, comprehe nsive, high-quality
maternal health-care services, and, within countries, incorporating into all sectors of
national budgets policy and programmatic approaches to address inequities and reach
poor women and girls and those in vulnerable situations;
(f) Establishing or strengthening, as appropriate, a national task force for
obstetric fistula, with a lead governmental entity, to enhance national coordination
and improve partner collaboration to end obstetric fistula, including partnering with
in-country efforts, to increase surgical capacity and to promote universal access to
essential and life-saving surgery;
(g) Strengthening the capacity of health-care systems, in particular public
health systems, to provide the essential services needed to prevent obste tric fistula
and to treat existing cases by increasing national budgets for health, ensuring that
adequate funds are allocated to reproductive health, including for obstetric fistula,
ensuring access to fistula treatment through increased availability of t rained, expert
fistula surgeons and permanent, holistic fistula services integrated into strategically
selected hospitals, thereby addressing the significant backlog of women and girls
awaiting surgical repair of fistula, and encouraging communication amon g fistula
centres to facilitate training, research, advocacy and fundraising and the application
of relevant medical standards, including consideration of the use of the World Health
Organization manual entitled Obstetric Fistula: Guiding Principles for Clinical
Management and Programme Development, which provides background information
6/8
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