situation of nepali women with uterine prolapse problem deliver conferen… · ·...
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Situation of Nepali Women with Uterine Prolapse Problem
Samita PradhanWomen’s Reproductive Rights Program
7-9 June 2010Women Deliver Conference
Washington DC
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Presentation Overview
• Why we talk about UP
• What is UP
• Prevalence in Nepal
• Causes
• Impacts
• Treatment
• Prevention
• Addressing the problem by Government and Civil Society
• Way Forward
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Why we talk about Uterine Prolapse?
• Issue of Maternal Health
• Morbidity Issue
• Caused by
oUnsafe Child Delivery Practices
oUnequal gender relations
oLack of access to health services
• Worsened by Poverty
• Problem of young women in Nepal
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CAED-WRRP’s Involvement
Drawn on the UP issue in
1999
many women were found
fallen womb
working with couples on
agro-forestry activities in
western region in Nepal
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• Falling of Womb
• Gradually descents downwards pelvis
First Stage
Second Stage
Third Stage
What is Uterine Prolapse ?
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• 600,000 women are living with painful condition –7%-35%
• Across the country
• Women of all Ages (adolescents to post menopausal stage)
• Women from all geographical areas
• Women from all ethnic group
Prevalence in Nepal
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Direct Causes
Early Age Child Delivery
High Parity & low birth spacing
Poor birthing practices
Abdominal pressure during Birth
Heavy Workload/Lifting and carrying load
Malnutrition
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Aggravating Causes
Lack of access to safe birthing centres
Lack of knowledge & education
Subordination Status of Women
Harmful Cultural Practices
Social Taboos
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Impacts
• Standing
• Sitting
• Walking
• Urinating
• Defecating
• Painful Intercourse
• Foul white discharge
• Abdominal Pain
• Backache
Physical
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• Painful, humiliating
• Reduces wellbeing
• Social exclusion
• Family breakdown
• Reduces productivity
• Direct affect in care of children
Socio-Economic
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Psychological
• Isolated
• Depression
• Anxiety
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Photo Courtesy: Dr Dangal
Treatment
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It is far more than a health problem
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How it is being addressed ?
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WRRP-CAED
Preventive Education Enhancing Capacities
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Contd…
AdvocacyExemplary
Curative Support
WRRP-CAED
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Government
• UP Included in National RH Strategy
• Mobile camps for 8,000 free surgical treatment
• National Multi-sectoral Strategic Action Plan Developed by GoN and UNFPA
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International Agencies
• World Bank-Nepal
• UNFPA-Nepal
• Helvetas-Nepal
• Fastenopfer-Switzerland
• Asian Aid Organisation-Australia
• The Advocacy Project-USA
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Way Forward……
• Need for solidarity for:
• Establishing UP as an issue of Reproductive rights
• Establishing UP as a major Maternal Morbidity Issue
• Integrating UP into other relevant RH components
• Research on Contributing Factors