Enhancing primary health care providers’ capacity in screening and referral of women with fistula

Abstract

Aims: To describe PHC providers’ perspectives on the intervention and differences between intervention and comparison districts in PHC providers’ fistula-related capacity.

Methods: At intervention endline, structured interviews were conducted across 50 PHCs in intervention (n=22) and comparison (n=28) districts with 100 providers on their knowledge of fistula screening, counseling and referral, perceived access barriers and experience implementing the intervention.

Results: More than a third of trained providers used the job aid to screen for OF, while 25% used the hotline at least once. Half thought the transportation voucher was the most important intervention component, while 70% selected community agents. Awareness of emergency obstetric care as a prevention strategy was significantly higher in intervention than comparison district (56% v. 16%; p <0.001).  A higher proportion of providers in intervention sites recognize and refer women with fistula symptoms (38% v. 26%).

Conclusions: Strengthening PHC provider capacity can improve screening and referral of fistula patients in marginalized areas, reducing barriers to repair.