Journal Articles

Striving for excellence: Nurturing midwives' skills in Freetown, Sierra Leone. Midwifery, March 2013, Volume 29, Issue 6
Carrie Ngongo, Kate Christie, Jude Holden, Carolyn Ford and Celia Pett describe the techniques used for ongoing staff development of midwives in the Aberdeen Women's Centre in Sierra Leone. Their success in this endeavor was dependent on an environment of supportive supervision, continuing education, enabling policies, and access to equipment and referral facilities.

Development and Comparison of Prognostic Scoring Systems for Surgical Closure of Genitourinary Fistula. AJOG, February 2013, Volume 208, Issue 2
Vera Frajzyngier, Joseph Ruminjo, and Mark Barone test the diagnostic performance of five existing classification systems and a prognostic scoring system that was derived empirically from prospective data to predict fistula closure three months after surgery. They find the prognostic values of existing urinary classifications systems and the empirically derived score were poor to fair suggesting that further evaluation of existing classification systems to predict fistula closure is warranted.

Factors Influencing Choice of Surgical Route of Repair of Genitourinary Fistula, and the Influence of Route of Repair on Surgical Outcomes: Findings from a Prospective Cohort Study BJOG, October 2012, Volume 119, Issue 11
Read the abstract in French
Vera Frajzyngier, Joseph Ruminjo, Mark Barone, et al. find that using a vaginal route for surgical fistula repair was associated with increased risks of failed fistula closure. While reasons for this remain unclear, the analyses suggest that the risk of failed fistula closure among women repaired vaginally was particularly elevated for those women who met indications for an abdominal repair.

Factors Influencing Urinary Fistula Repair Outcomes in Developing Country Settings: A Systematic Review of the Literature American Journal of Obstetrics and Gynecology, October 2012, Volume 207, Issue 4.
Read the abstract in French
Vera Frajzyngier, Joseph Ruminjo, and Mark Barone review the literature examining factors influencing urinary fistula repair outcomes in developing countries.

Determinants of Fistula Repair Post-Operative Outcomes: A Prospective Cohort Study Obstetrics and Gynecology, September 2012, Volume 120, Issue 3.
Read the abstract in French
Vera Frajzyngier, Joseph Ruminjo, Mark Barone discuss results indicating that prognosis for genital fistula closure is related to preoperative bladder size, history of fistula repairs, vaginal scarring, and urethral involvement from a multi-country prospective cohort study.

Non-Inferiority of Short-Term Urethral Catheterization Following Fistula Repair Surgery: Study Protocol for a Randomized Controlled Trial BMC Women's Health 2012, 12:5.
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Mark Barone, Vera Frajzyngier, Steven Arrowsmith, Joseph Ruminjo, Armando Seuc, Evelyn Landry, Karen Beattie, Thierno Hamidou Barry, Alyona Lewis, Mulu Muleta, Dolorès Nembunzu, Robert Olupot, Ileogben Sunday-Adeoye, Weston Khisa Wakasiaka, Mariana Widmer, and Metin Gulumezoglu compare the new proposed short-term (7 day) urethral catheterization to longer-term (14 day) in terms of predicting fistula repair breakdown.

Current Practices in Treatment of Female Genital Fistula: A Cross Sectional Study BMC Pregnancy & Childbirth 2010, 10:73.
Steve D. Arrowsmith, Joseph Ruminjo, and Evelyn Landry provide a look into current practices in fistula treatment and care across geographic, economic, and organizational considerations and find common practices in some areas with diverging practices in others.

Fistula and Traumatic Genital Injury from Sexual Violence in a Conflict Setting in Eastern Congo: Case Studies Reproductive Health Matters, May 2008, Volume 16, Issue 31.
Ahuka Ona Longombe, Kasereka Masumbuko Claude, and Joseph Ruminjo document stories from sexual violence survivors in the Democratic Republic of the Congo.

Obstetric Fistula and the Challenge to Maternal Health Care Systems (PDF, 388KB) IPPF Medical Bulletin, Vol. 41, No. 4, December 2007.
Joseph Ruminjo summarizes the maternal health and systematic challenges faced in the fight against fistula.