Submission ID 131626
| Issue/Objective | Within Project Zero, we implement multifaceted interventions to prevent obstetric fistula which is childbirth injuriy caused by prolonged obstracted labor; through community engagement, capacity building, patient identification and treatment, and strengthening maternal healthcare services. Understanding stakeholders' perspectives is essential to identify components influencing intervention effectiveness. Aim: To explore the components influencing a multifaceted intervention in obstetric fistula elimination from the stakeholders' perspective. |
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| Methodology/Approach | The study was conducted in Tigray, a conflict-affected region in northern Ethiopia, where disruptions to health services have significantly impacted access to maternal healthcare. A qualitative study design was employed using semi-structured in-depth interviews and focus group discussions with purposively selected stakeholders, including healthcare personnel, midwives, health extension workers, community leaders, and beneficiaries, to capture diverse perspectives across community and health system levels. Data were analysed using reflexive thematic analysis to identify key themes related to intervention effectiveness and health system resilience. The study was conducted from December 2024 to October 2025. |
| Results | Stakeholders described perceived components influencing intervention effectiveness: raising awareness and promoting health-seeking behavior; capacity building and mentorship of healthcare personnel; midwives' leadership in monitoring and managing maternal care; accessibility of services, including free transportation and referrals; and multisectoral collaboration and community engagement. Effective implementation relied on combining community education, health system strengthening, and supportive referral pathways. |
| Discussion/Conclusion | Project Zero demonstrates that holistic interventions addressing both social determinants and health system limitations are critical for preventing obstetric fistula. Stakeholders emphasized that sustainable change requires flexible, community-informed approaches integrated into existing maternal health services. The study highlights the importance of community engagement, workforce capacity, midwifery leadership, and accessible services in multifaceted obstetric fistula prevention programs. |
| Presenters and Affiliations | Helena Lindgren Karoliniska Institutet Michael Wells Karoliniska Institutet Kerstin Erlandsson Dalarna University Tewodros Seyoum Karoliniska Institutet HANNA TESFAYE Sisay Hamlin Fistula Ethiopia |
