Study setting and sites

Our research is situated in Uganda which reports a lifetime fistula symptom prevalence of 19.2 per 1,000 reproductive aged women and ~ 5,000 new cases annually.^36–38 Uganda’s National Fistula Technical Working Group (est. 2002) with representatives from the Ministry of Health, international and national non-governmental organizations (NGOs), medical professionals, and media has focused on increasing fistula surgery availability; from 2010 to 2015 the annual number of fistula surgeries in Uganda increased from 1377 to 2065.³⁹ Fistula surgery is available at 20 centers of excellence in Uganda, with 25 trained surgeons with various levels of experience employed by national and regional referral hospitals. Regional literature suggests that genital fistula repair is successful among ~ 80% of affected women.^18,40

The research team is partnering with approximately 12 facilities across Uganda providing fistula repair, selected for fistula repair volume, geographic proximity, prior collaboration and research capability (Fig. 3). Various fistula repair models are used across these sites; some sites conduct routine surgeries within ongoing urogynecological services only, others conduct fistula repair camps only, and others combine both routine care and camp models. Patients who are under the care of our study providers and research assistants at alternative inconsistent locations will be considered eligible for study participation if they meet study eligibility criteria.

Partnering fistula repair study sites across Uganda