Obstetric fistula is a devastating child birth injury that has been severely neglected, despite the traumatizing impact it has on the lives of affected women and girls. This publication is intended for learners, facilitators and supervisors to be completed using an on-the-job training approach either in their workplaces or in different facilities. With the training package, service providers are expected to have comprehensive knowledge about obstetric fistula on how to provide quality care.

This Reference Manual is developed by the Ministry of Health and Population with technical and financial assistance from UNFPA, the United Nations Population Fund, and also with Jhpiego's technical support.

Obstetric fistula was not officially recognized in Nepal until UNFPA'sCampaign to End Fistula was launched in 2010. As part of the campaign, UNFPA works with the government and other stakeholders to support prevention and treatment by building the capacity of health institutions and service providers.