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With the completion of Nepal's first innovative hands-on training on obstetric fistula, an end to the shortage of competent service providers is in sight now. One of the most serious injuries of childbearing, obstetric fistula is a hole in the birth canal, caused by prolonged, obstructed labor due to lack of timely and adequate medical care, early or closely spaced pregnancies.
The four-month Obstetric Fistula on-the-job-training, conducted at B.P. Koirala Institute of Health Sciences (BPIKHS), Dharan, was completed in September 2014. The training started in May, during the same week that Nepal celebrated the 2nd International Day to End Obstetric Fistula. It was organized by National Health Training Center (NHTC), Ministry of Health and Population, with the financial and technical support of UNFPA, the United Nations Population Fund, and Jhpiego. 
The purpose of this intensive training was to enable dedicated doctors and nurses to acquire the knowledge, skills and the professionalism needed to prevent obstetric fistula and provide proper surgical, medical and psychological care to women who have developed a fistula, whether during childbirth or because of other causes. Two gynecologists and two nurses were the trainees.

Earlier in April this year, a quadripartite Memorandum of Understanding (MoU) was signed between NHTC, UNFPA, Jhpiego and BPKIHS for developing BPKIHS as a designated obstetric fistula training site. UNFPA, in partnership with Jhpiego, has been working for the development of comprehensive reproductive health training sites and competency based training manuals on Obstetric Fistula since 2013.

The closing ceremony of the training held at BPKIHS was attended by senior government officials from the Family Health Division (FHD) and NHTC, UNFPA Representative Giulia Vallese, Country Director of Jhpiego Chandra Rai as well as officials from UNFPA, Jhpiego and BPKIHS. On the occasion, the trainees said they gained comprehensive knowledge and developed skills on obstetric fistula management and expressed their satisfaction to be part of the country's first obstetric fistula training. 
Addressing the event, FHD Director Dr. Kiran Regmi acknowledged UNFPA's contributions in ending and preventing obstetric fistula in Nepal. At the same function, Giulia hailed the government's commitment to provide quality care to women suffering from obstetric fistula.
Obstetric fistula was only officially recognized after the launch of the Campaign to End Fistula in Nepal in 2010. As part of the campaign, UNFPA is working with the Government of Nepal to end and prevent obstetric fistula, support surgeries and provide capacity building to health institutions and service providers. 
For more information on the campaign, please visit: www.endfistula.org