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Lady of Niger, Dr Lalla Malika Issoufou, partners and the United Nations Population Fund in West and Central Africa Regional Office (UNFPA WCARO) to step up support and mobilize resources to eliminate obstetric fistula in West and Central Africa, before 2030.

The First Ladies committed to mobilizing more resources and gear up to support the fight during a high-profile roundtable conference organized under the theme, "Strengthened and extended partnership: An essential lever for the elimination of obstetric fistula." The heavily attended hybrid event held on Tuesday, 23 March 2021, under the First Lady of Niger's patronage, Dr Lalla Malika Issoufou.

Against the backdrop of the inability to treat the growing number of fistula cases annually and the backlog of cases, Dr Malika Issoufou issued a clarion call to raise the needed resources.

“I call for the mobilisation of the necessary resources to put an end to this attack on the health and human rights of women and girls, which strips them of their dignity and makes them lose all hope.” She noted, urging other First Ladies and partners alike to work together to wipe fistula off the map of West and Central Africa.

Firts Lady of Niger, Dr Lalla Malika Issoufou received distinction from Mabingue Ngom, and paid tribute to UNFPA.

Officially opening the roundtable, Dr. Malika Issoufou noted that surgical care is free for obstetric fistula care in Niger. Niger has 11 treatment centres and 23 active surgeons, with an average of 500 cases treated annually. In 2018, on the occasion of the international day against obstetric fistula, she had launched the integration of obstetric fistula management in the training curriculum of surgeons and obstetrician-gynaecologists.

She paid tribute to UNFPA, which in 2003 launched the global campaign to eliminate obstetric fistula, a campaign based on three strategic axes: prevention, treatment and socio-economic reintegration.

On his part, Mabingue Ngom, UNFPA Regional Director for West and Central Africa, reiterated the need to focus on prevention. At the same time, repairs and reintegration are ongoing for the backlog of cases. He expressed gratitude to the First Ladies and partners gathered to launch the regional strategy and their steadfast commitment to launch the first regional strategy to eliminate obstetric fistula.

“Fistula is indeed preventable and treatable,” Mr, Ngom emphasized, noting child marriage, early pregnancy, and female genital mutilation as factors that contribute to obstetric fistula.

“We need to work together effectively: scientific communities and learned societies, civil society organizations, NGOs, religious and traditional leaders, United Nations agencies, the African Union, Regional Economic Commissions such as ECOWAS and ECCAS, the Organization of First Ladies and governments.” Mabingue Ngom highlighted while underlining the critical and complementary role of these stakeholders.

Regional round table against fistula, Niamey.

The objectives roundtable objectives, were amongst others, to enhance advocacy, extend partnerships mobilise additional resources, including domestic resources, to ensure the regional plan’s efficient implementation to eliminate obstetric fistula in West and Central Africa.

Since 2003 UNFPA and its partners have been involved in the Campaign to End Obstetric Fistula, in which approximately 85,000 women and girls received restorative treatment. Nonetheless, more than two million more women continue to suffer from obstetric fistula, more than half of them in West and Central Africa - continue to live in disgraceful conditions.

Despite the efforts made to help them, it is essential to recognize that the pace remains slow. In 2018, 2,281 women received treatment in the region. The latest estimates show that between 600,000 and 1,000,000 cases are awaiting treatment.

In West and Central Africa, there are several direct and indirect causes of obstetric fistula. These included high demographic growth (2.7%), the highest total fertility rate in the world (5.2 children per woman), poor access to reproductive health services, tall child marriage prevalence (42%), and female genital mutilation (24%). FGM can reach 90% in some countries such as Sierra Leone, Mali and Guinea. To these is added the traditional low enrollment of girls (24%).

Women who suffer from fistulae due to childbirth, on average, suffer from this disease for 7.5 years of their life. This period generally corresponds to the first years of entering the labor market, which are thus sacrificed. More recently, the security threat in the Sahelian strip and the COVID-19 pandemic has imposed an unprecedented limitation on the movements and displacements of populations, especially women and girls, thus limiting their access to reproductive health services. Besides, already fragile health services have seen their capacity to provide quality care greatly impacted. All of these indicators are not likely to promote the eradication of fistula and the care of patients.

An investment case conducted by UNFPA shows that women with obstetric fistula live an average of 7.5 years with an annual financial impact of $30 million in the region, at $1,000 per woman. Treating each patient requires an investment of $1,500. Treating 67,000 women with the condition and inserting 54,000 would cost $86 million, compared to the $540 million cost of doing nothing. In other words, investing $16 to treat fistula cases saves $100. KOICA, since 2012 has addressed the problem and spent $16 million to raise awareness and treat the disease, resulting in the treatment of 4,770 women. It is up to us to address this issue at the crossroads of several Sustainable Development Goals (SDGs), so that "no one is left behind", especially not the most vulnerable women.

Other First Ladies included H.E. Brigitte TOUADERA, First Lady of the Central African Republic, H.E. Hinda Déby ITNO First Lady of Chad, H.E. Mrs Ambari Azali, First Lady of the Islands of Comoros, H.E. Mrs. Antoinette Sassou Nguesso, First Lady of the Republic of Congo, H.E. Mrs Mariem Dah, First Lady of the Islamic Republic of Mauritania, and H.E. Mrs. Fatima Maada Bio, First Lady of Sierra Leone. Each of the First Ladies took turns to voice their support favouring the fight to mobilize the needed resources and support to eradicate obstetric fistula.

Other high profile participants included the Africa Regional Director of the World Health Organisation Dr Matshidiso Rebecca Moeti, the ECCAS Commissioner for Gender, Human and Social Development H.E. Yvette Ngandu Kapinga, UN Women Representative for West and Central Africa, Ms. Oulimata Sarr, and a representative of the ECOWAS Commissioner for Social Affairs and Gender of ECOWAS.

Traditionnal leaders at the regional round table againts fistula, Niamey

Some of the partner organisations who voiced their continuous support are: KOICA, TOSTAN, Islamic Development Bank, and USAID.

The roundtable conference was hugely successful in physical and virtual participation alike. Over 150 participants converged at the Niger Congress Hall, including Government officials, UN agencies, Traditional and Religious Leaders. Connected online on Zoom were 250 participants connected from 45 countries as well as over 400 followed on Livestream across different social media platforms.

Access a complete recording of the roundtable on UNFPA WCARO.



Habibou DIA, | Media Specialist | UNFPA WCARO |Phone: +221 78 620 45 13 |


Souleymane Saddi Maazu | Programme Communication and Advocacy Officer | UNFPA Niger | Tel. +227 20 72 29 80 ; +227 92 19 83 56 | E-mail :