Situation of Nepali Women with Uterine Prolapse Problem

Samita PradhanWomen’s Reproductive Rights Program

7-9 June 2010Women Deliver Conference

Washington DC

Presentation Overview

• Why we talk about UP

• What is UP

• Prevalence in Nepal

• Causes

• Impacts

• Treatment

• Prevention

• Addressing the problem by Government and Civil Society

• Way Forward

Why we talk about Uterine Prolapse?

• Issue of Maternal Health

• Morbidity Issue

• Caused by

oUnsafe Child Delivery Practices

oUnequal gender relations

oLack of access to health services

• Worsened by Poverty

• Problem of young women in Nepal

CAED-WRRP’s Involvement

Drawn on the UP issue in

1999

many women were found

fallen womb

working with couples on

agro-forestry activities in

western region in Nepal

• Falling of Womb

• Gradually descents downwards pelvis

First Stage

Second Stage

Third Stage

What is Uterine Prolapse ?

• 600,000 women are living with painful condition –7%-35%

• Across the country

• Women of all Ages (adolescents to post menopausal stage)

• Women from all geographical areas

• Women from all ethnic group

Prevalence in Nepal

Direct Causes

Early Age Child Delivery

High Parity & low birth spacing

Poor birthing practices

Abdominal pressure during Birth

Heavy Workload/Lifting and carrying load

Malnutrition

Aggravating Causes

Lack of access to safe birthing centres

Lack of knowledge & education

Subordination Status of Women

Harmful Cultural Practices

Social Taboos

Impacts

• Standing

• Sitting

• Walking

• Urinating

• Defecating

• Painful Intercourse

• Foul white discharge

• Abdominal Pain

• Backache

Physical

• Painful, humiliating

• Reduces wellbeing

• Social exclusion

• Family breakdown

• Reduces productivity

• Direct affect in care of children

Socio-Economic

Psychological

• Isolated

• Depression

• Anxiety

Photo Courtesy: Dr Dangal

Treatment

It is far more than a health problem

How it is being addressed ?

WRRP-CAED

Preventive Education Enhancing Capacities

Contd…

AdvocacyExemplary

Curative Support

WRRP-CAED

Government

• UP Included in National RH Strategy

• Mobile camps for 8,000 free surgical treatment

• National Multi-sectoral Strategic Action Plan Developed by GoN and UNFPA

International Agencies

• World Bank-Nepal

• UNFPA-Nepal

• Helvetas-Nepal

• Fastenopfer-Switzerland

• Asian Aid Organisation-Australia

• The Advocacy Project-USA

Way Forward……

• Need for solidarity for:

• Establishing UP as an issue of Reproductive rights

• Establishing UP as a major Maternal Morbidity Issue

• Integrating UP into other relevant RH components

• Research on Contributing Factors