Research & Action Report, Spring/Summer 2014

tinyglobeTracy Gladstone, Ph.D., senior research scientist and director, RobertS. and Grace W. Stone Primary Prevention Initiatives at WCW, travelled to Ethiopia in May with Phyllis Rothberg, LICSW, and Tsega Meshesha, B.A., research associates, for the first stage of a new project to develop, implement, and pilot test a low-cost, evidence­ based depression intervention for women who are in the hospital recovering from fistula repair surgery. Collaborating with Women and Health Alliance International (WAHA), headquartered in Paris, France, co-principal investigators are Gladstone and Mulu Muleta, M.D., Ph.D., country director, WAHA Ethiopia.

Obstetric fistula is a serious obstetric complication that occurs in approximately 50,000-100,000 women each year, generally as a result of prolonged obstructed labor. Efforts to address obstetric fistula worldwide have focused primarily on the physical consequences of this problem; systematic efforts to address the psychological consequences of obstetric fistula, and particularly depression, have been nearly nonexistent. During the recent site visit, ten qualitative interviews were conducted with clinicians at the Fistula Center in Gondar, Ethiopia. Stakeholders noted that they would be interested in learning more about how to address the mental health needs of fistula patients and reported they would be willing to learn to imple­ menta new intervention. The next stages of the project will include qualitative interviews with fistula patients, followed by the intervention development, training, and implementation.

This pilot study will provide preliminary data for a larger, multi-year, countrywide randomized trial to examine the effi­ cacy of an evidence-based intervention targeting the prevention of depression in women recovering from fistula repair surgery. Through this collaboration with WAHA and the Hamlin Fistula Hospital, Gladstone will be able to access the primary fistula care sites throughout Ethiopia, and will be able to explore the added value of addressing mental health, in order to enhance the standard of care for fistula patients countrywide. 

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