In December 2012, 167 countries co-sponsored a biannual resolution of the United Nations General Assembly that called on all Member States to support the activities of UNFPA and its partners in the Campaign to End Fistula. The resolution also called for greater technical and financial support, in particular to high-burden countries, in order to accelerate progress towards achieving Millennium Development Goal 5: increasing maternal health, including eliminating obstetric fistula. It also underlined the need to accelerate effort to address child marriage. In addition, the UNFPA-backed resolution on Supporting Efforts to End Obstetric Fistula acknowledged the plight of millions of women and girls living with obstetric fistula by designating 23 May as the International Day to End Obstetric Fistula. The Day was observed for the first time in 2013.

Women and girls at risk of or living with fistula faced structural and systemic barriers to care before the COVID-19 pandemic. As health systems across the globe struggle to cope with the COVID-19 response, and sexual and reproductive health services risk being sidelined, denial or lack of access to sexual and reproductive health services would be especially devastating for such women and girls, who are already dealing with economic, social, cultural and logistical barriers to care, further deepening pre-existing inequalities. 
A sign of global social injustice and inequity stemming from weak health systems, fistula is driven by social determinants including poverty, gender and socioeconomic inequality, lack of education, child marriage and early/adolescent childbearing. UNFPA estimates that COVID-19 will result in an additional total 13 million child marriages taking place that otherwise would not have occurred between 2020 and 2030. Additionally, the pandemic is causing disruption to meeting family planning needs. Some 47 million women in 114 low- and middle-income countries are projected to be unable to use modern contraceptives if the average lockdown – or COVID-19-related disruption – continues for 6 months with major disruptions to services.

End the Shame. End the Isolation. End Fistula.

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