Preventing Obstetric Fistula Through Health Systems Strengthening in Uganda

Obstetric fistula is a preventable childbirth injury that reflects gaps across the continuum of care. In Uganda, prolonged obstructed labor and birth injuries remain leading causes of fistula, while an increasing proportion of cases occur among adolescent girls (aged 19 and younger). Eliminating obstetric fistula requires more than surgical repair; it demands stronger health systems that delay first pregnancies, expand access to sexual and reproductive health (SRH) services, improve the quality of maternal and emergency obstetric care, and ensure timely referral and treatment. Through the USAID-funded Family Planning Activity (2020-2025) and the FCDO-funded Empowering Women for Better Reproductive Health Outcomes (EMPOWER) programme, Pathfinder International partners with the Government of Uganda to strengthen the health system and prevent obstetric fistula before it occurs. Our integrated, data-driven approach addresses the root cause of birth injuries by combining adolescent SRH, quality maternal and emergency obstetric services, strengthened referral systems, and clinical capacity in treatment and recovery to improve outcomes across the continuum of care. By embedding these interventions within existing government structures, Pathfinder strengthens the capacity to prevent, detect, refer, and manage obstetric complications while building a more sustainable maternal health system.