About This Report
“I Am Not Dead, But I Am Not Living”
July 15, 2010

“I Am Not Dead, But I Am Not Living”

Barriers to Fistula Prevention and Treatment in Kenya

Summary
Key Recommendations to the Kenyan Government
Methodology
I. Background
Maternal Mortality and Morbidity Globally
Fistula Globally
Causes of Fistula
International Response to Fistula
Key Data on Maternal Health and Fistula in Kenya
Relevant Policies
II.Impact on the Lives of Women and Girls in Kenya
Physical and Psychological Consequences
Social Consequences
Economic Consequences
III. Kenya’s Obligations under International, Regional, and National Law
The Right to Health
The Right to Information
Right to Equality and Non-Discrimination
The Right to a Remedy
IV. Access to Health Information
Sexuality Education
Family Planning Information
Information on the Need for Facility Deliveries
Information on What Fistula Is and Treatment Availability
V.Availability and Accessibility of Services
Family Planning
Human Resource Constraints
Poor Access to Emergency Obstetric Care
Facility and Staffing Challenges for Fistula Repairs
Health System Financing, Funding for Maternal Health Care and Fistula Repairs
Lack of Reintegration Assistance
Costs to Users in the Public Health System
VI. Patients’ Rights and Health System Accountability
Mistreatment and Neglect by Health Care Providers
Inadequate Patients’ Rights and Grievance Mechanisms
VII.Detailed Recommendations
VIII. Appendix I
IX. Acknowledgements