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Fistula is undoubtedly one of the major deprivations of girls’ and women's health and rights. Girls and women suffering from obstetric fistula often experience complications such as infections, urine loss accompanied by a bad smell, kidney disease, infertility, as well as social isolation. This condition prevents them from participating fully in community activities and from securing long-term employment and a fulfilling life. It is estimated that around 2,300 new cases of obstetric fistula occurred in Mozambique in 2015. Currently, the country’s health system has the capacity to treat approximately 600 cases. There are immense challenges with data collection and analysis on this matter, which hinders the capacity to provide fistula survivors with high-quality services along the cycle of care, starting from identification, and going through diagnosis, treatment, control, and reintegration in the community.

Since December 2017, UNFPA Fistula Project in Mozambique has supported the country’s National Obstetric Fistula Strategy (2012-2020) by focusing on prevention, treatment, and social integration. As part of this support, UNFPA is supporting the Mozambican Ministry of Health to build a Real-Time Monitoring System (RTM) named InfoFistula, with the technical assistance of a Charity-based organization, Operation Fistula. The real-time monitoring application based on Commcare aims at providing data to inform the situation and bottlenecks in the cycle of care. The specific objectives of InfoFistula are to (1) provide regular information to implementing partners about key activities that have taken place in the communities and health facilities; (2) provide reports and dashboards for operational management at district and provincial levels and (3) collect data on programme results indicators to monitor and measure the fistula programme results and progress. 

InfoFistula is built as an easily customizable, mobile App that supports frontline workers for data collection and service delivery. InfoFistula helps to document and improve every interaction between a fistula patient and her care team across the cycle of care. The submitted data is processed for further analysis into a dashboard that provides clear and dynamic visualizations on the data trends.

Launch of pilot phase in Cabo Delgado province ©UNFPA Mozambique

A pilot phase started in September 2019 in three provinces, Zambezia, Nampula, and Cabo Delgado. During this time, 45 health and social action workers were trained on the use of the App and dashboard and are currently using the App during their interactions with obstetric fistula patients. The pilot will serve to assess and improve the performance, functionality, usability, and efficacy of InfoFistula App and it will also contribute towards knowledge transfer to the Ministry of Health to guarantee they are able to analyze and use data collected and provide assistance to the app users.

Up to December 2019, InfoFistula has been functional, the dashboard is showing 114 patients registered, and it has been possible to collect valuable feedback to make improvements to the tool. A scale-up phase has been planned with partners consisting of further training and capacity building for the Ministry of Health, deployment of the tool in more provinces, and technical transfer of the app to the Ministry’s data management system.