Supporting Efforts to End Obstetric Fistula

A/RES/65/188View PDF

Who adopted this document and its mandates?

A Resolution of the General Assembly, under agenda item 28a Advancement of women, published in 2011.

What other versions does this mandate have?

4 versions · 2008–2013

This is an older version — the most recent is A/RES/67/147

Year	Symbol	Title	Word length	Text similarity
2013	A/RES/67/147	Supporting efforts to end obstetric fistula	2,692	54%Compare
2011	A/RES/65/188	Supporting efforts to end obstetric fistula	2,237	77%Compare
2009	A/RES/63/158	Supporting efforts to end obstetric fistula	1,794	83%Compare
2008	A/RES/62/138	Supporting efforts to end obstetric fistula	1,646	–

Which reports were submitted under this mandate?

3 reports · 2010–2014

Year	Symbol	Title	Mandate resolution
2014	A/69/256	Supporting efforts to end obstetric fistula report of the Secretary-General	A/RES/67/147
2012	A/67/258	Supporting efforts to end obstetric fistula report of the Secretary-General	A/RES/65/188
2010	A/65/268	Supporting efforts to end obstetric fistula report of the Secretary-General	A/RES/63/158

What’s in this document?

25 operative paragraphs

Recognizes the interlinkages between poverty, malnutrition, lack of or inadequate or inaccessible health services, early childbearing, early marriage of the girl child and gender discrimination as root causes of obstetric fistula, that poverty remains the main social risk factor, that the eradication of poverty is critical to meeting the needs and protecting and promoting the rights of women and girls and that continued urgent national and international action is required to eliminate it;

Stresses the need to address the social issues that contribute to the problem of obstetric fistula, such as early marriage of the girl child, early pregnancy, lack of access to sexual and reproductive health, lack of or inadequate education of women and girls, poverty and the low status of women and girls;

Also stresses that States have the obligation to promote and protect all human rights and fundamental freedoms of women and girls, that they must exercise due diligence in order to prevent, investigate and punish the perpetrators of violence against women and girls and to provide protection to the victims, and that failure to do so violates and impairs or nullifies the enjoyment of their human rights and fundamental freedoms;

Calls upon States to take all measures necessary to ensure the right of women and girls to the enjoyment of the highest attainable standard of health, including sexual and reproductive health, and to develop sustainable health systems and social services, with a view to ensuring access to such systems and services without discrimination, while paying special attention to adequate food and nutrition, water and sanitation, family planning information, increasing knowledge and awareness and securing appropriate prenatal and post-natal care for the prevention of obstetric fistula;

Also calls upon States to ensure the right to education for women and girls, of good quality, on an equal basis with men and boys, and to ensure that they complete a full course of primary education, and to renew their efforts to improve and expand girls’ and women’s education at all levels, including at the secondary and higher levels, as well as vocational education and technical training, in order, inter alia, to achieve gender equality, the empowerment of women and poverty eradication;

Urges States to enact and strictly enforce laws to ensure that marriage is entered into only with the free and full consent of the intending spouses and, in addition, to enact and strictly enforce laws concerning the minimum legal age of consent and the minimum age for marriage, and to raise the minimum age for marriage where necessary;

Calls upon the international community to support the activities of the United Nations Population Fund and other partners in the global Campaign to End Fistula, including the World Health Organization, in establishing and financing regional fistula treatment and training centres, and where necessary national centres, by identifying and supporting health facilities that have the potential to serve as centres for treatment, training and convalescent care;

Calls upon States to accelerate progress in order to achieve Millennium Development Goal 5 and its two targets by addressing reproductive, maternal, newborn and child health in a comprehensive manner, inter alia, through the provision of family planning, prenatal care, skilled attendance at birth, emergency obstetric and newborn care and methods of prevention and treatment of sexually transmitted diseases and infections, such as HIV, within strengthened health systems that provide accessible and affordable integrated health-care services and include community-based preventive and clinical care, as also reflected in the outcome document of the High-level Plenary Meeting of the General Assembly on the Millennium Development Goals, entitled “Keeping the promise: united to achieve the Millennium Development Goals”,Error: Reference source not found and the Global Strategy for Women’s and Children’s Health;

Calls upon States and/or the relevant funds and programmes, organs and specialized agencies of the United Nations system, within their respective mandates, and invites the international financial institutions and all relevant actors of civil society, including non-governmental organizations, and the private sector:

To redouble their efforts to meet the internationally agreed goal of improving maternal health by making maternal health services and obstetric fistula treatment geographically and financially accessible, including by increasing access to skilled attendance at birth, emergency obstetric care and appropriate prenatal and post-natal care;

To develop, implement and support national and international prevention, care and treatment and socio-economic reintegration and support strategies, as appropriate, to address effectively the condition of obstetric fistula and to develop further a multisectoral, multidisciplinary, comprehensive and integrated approach in order to bring about lasting solutions and put an end to obstetric fistula, maternal mortality and related morbidities, including through ensuring access to affordable, comprehensive, quality maternal health-care services, including skilled birth attendance and emergency obstetric care;

To strengthen the capacity of health systems, in particular public health systems, to provide the essential services needed to prevent obstetric fistula and to treat those cases that do occur by providing the continuum of services, including family planning, prenatal care, skilled birth attendance, emergency obstetric care and post-partum care, to young women and girls, including those living in poverty and in underserved rural areas where obstetric fistula is most common;

To strengthen research, monitoring and evaluation systems, including community-based notification of obstetric fistula cases and maternal and newborn deaths, to guide the implementation of maternal health programmes;

To provide essential health services, equipment and supplies and skills training and income-generating projects to women and girls so that they can break out of the cycle of poverty;

To mobilize funding to provide free or subsidized fistula repairs, including through encouraging more networking among providers and the sharing of new treatment techniques and protocols;

To improve data collection, pre- and post-surgery, to measure progress in addressing the needs for surgical treatment and the quality of surgery, rehabilitation and socio-economic reintegration services, including post-surgery prospects for successful subsequent pregnancies, live births and severe health-related complications so as to address the challenges for improving maternal health;

To provide health education, rehabilitation and socio-economic reintegration counselling, including medical counselling, as key components of post-operative care to all women after fistula treatment, including to those with irreparable cases;

To bring obstetric fistula to the attention of policymakers and communities, thereby reducing the stigma and discrimination associated with it and helping women and girls suffering from obstetric fistula so that they can overcome abandonment and social exclusion together with the psychosocial implications thereof, inter alia, through the support of social reintegration projects;

To educate individual women and men, girls and boys, communities, policymakers and health professionals about how obstetric fistula can be prevented and treated, and increase awareness of the needs of pregnant women and girls, as well as of those who have undergone surgical fistula repair, including their right to the highest attainable standard of health, by working with community and religious leaders, traditional birth attendants, women and girls who have suffered from fistula, the media, radio stations, influential public figures and policymakers, support the training of doctors, midwives, nurses and other health workers in lifesaving obstetric care, and include training on fistula repair, treatment and care as a standard element of the training curricula of health professionals;

To develop means of transportation and financing that enable women and girls to access obstetric care and treatment, and provide incentives and other means to secure the presence in rural areas of qualified health professionals who are able to perform interventions to prevent obstetric fistula;

Encourages communication and networking among existing fistula centres to facilitate training, research, advocacy and fund-raising and the development and application of relevant standards, including Obstetric Fistula: Guiding Principles for Clinical Management and Programme Development,¹² which provides background information and principles for developing fistula prevention and treatment strategies and programmes;

¹²World Health Organization (Geneva, 2006). Available from www.who.int/reproductivehealth/ publications/maternal_perinatal_health/.

Urges the international community to address the shortages of doctors, midwives, nurses and other health workers trained in lifesaving obstetric care, and of space and supplies, that limit the capacity of most fistula centres;

Urges multilateral donors, and invites international financial institutions, within their respective mandates, and regional development banks to review and implement policies to support national efforts to ensure that a higher proportion of resources reaches young women and girls, in particular in rural and remote areas;

Invites Member States to contribute to efforts to end obstetric fistula, including, in particular, the United Nations Population Fund global Campaign to End Fistula, with the goal of eliminating obstetric fistula by 2015, in line with the targets of the Millennium Development Goal of improving maternal health;

Requests the Secretary-General to submit a report to the General Assembly at its sixty-seventh session on the implementation of the present resolution under the item entitled “Advancement of women”.

Supporting Efforts to End Obstetric Fistula

Who adopted this document and its mandates?

What other versions does this mandate have?

Which reports were submitted under this mandate?

What subjects does this mandate have?

What’s in this document?

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