Obstetric fistula exposes gaps in Kenya's maternal healthcare system

Obstetric fistula continues to expose deep gaps in Kenya’s maternal healthcare system, with thousands of women still developing the preventable childbirth injury due to delayed or inaccessible emergency obstetric care.

Despite advances in maternal healthcare, the condition remains a silent crisis, particularly in rural and underserved areas where access to health facilities, skilled birth attendants and timely referral systems remains limited.

The issue took centre stage during the commemoration of the International Day to End Obstetric Fistula held at Jamaa Mission Hospital in Nairobi.

The event, organised by Edelvale Trust in partnership with the Fistula Foundation, highlighted the urgent need for greater investment in maternal health systems to prevent prolonged and obstructed labour from resulting in life-altering injuries.

This year’s theme, “Her Health Is a Right: Invest to End Fistula and Childbirth Injuries,” emphasised the need for sustained investment in healthcare infrastructure, skilled personnel and community awareness.

Health experts and partners noted that ending obstetric fistula will largely depend on expanding access to trained healthcare workers, strengthening referral systems and improving maternal health education at the community level.

Obstetric fistula mainly develops after prolonged labour without timely medical intervention, leaving women with chronic incontinence and severe physical, emotional and social consequences.

Many survivors face stigma, isolation and rejection by partners, families and communities. In some cases, women are forced out of school, employment and social life, deepening poverty and vulnerability.

Kenya records an estimated 1,000 to 3,000 new fistula cases annually, yet only a small proportion of affected women access corrective surgery due to poverty, limited awareness, long distances to specialised hospitals and shortages of trained fistula surgeons.

“Obstetric fistula is more than a medical condition; it is a painful reminder of the inequalities that still exist in our healthcare systems,” said Nelson Musa, Program Director at Fistula Foundation.

“Behind every number is a mother, a daughter, a sister enduring unimaginable suffering, often in silence,” he added.

Health partners at the event stressed that prevention remains the most effective solution and called for stronger community healthcare systems, better training for midwives, nurses and community health promoters, and early identification of high-risk pregnancies.

They also underscored the importance of public awareness campaigns to combat myths and stigma that prevent many women from seeking treatment.

According to the Fistula Foundation, 19,577 surgeries were supported across Africa last year, with the organisation targeting 21,775 surgeries this year — an 11 per cent increase aimed at expanding access to treatment.

In Kenya, the Foundation works through a treatment network comprising 15 treatment partners, 17 hospitals and six outreach partners across Nairobi, Mombasa, Eldoret and other regions.

Speaking during the event, Rachel Muthoni of Jamaa Mission Hospital reaffirmed the hospital’s commitment to strengthening maternal healthcare services and supporting survivors.

“We are committed to working with partners to expand access to maternal healthcare, increase awareness, and ensure survivors receive the treatment and support needed to rebuild their lives,” she said.

The commemoration ended with renewed calls for increased investment in maternal healthcare systems, stronger community outreach and coordinated efforts to eliminate obstetric fistula and ensure no woman suffers from a preventable childbirth injury.