Many women in Bangladesh still give birth without medical assistance. This significantly increases the risk of developing an obstetric fistula. Our project combines prevention, individual and holistic support for affected women, and the targeted strengthening of local health services.
Lutheran Aid to Medicine in Bangladesh (LAMB), one of the leading healthcare providers in the project region with a strong focus on maternal and child health.
A strengthened healthcare system will help to reduce the number of obstetric fistula cases in Rajshahi District. At the same time, the quality of life for fistula survivors and women of reproductive age will improve.
Training healthcare professionals, providing medical support and individual follow-up care for women affected by fistula, as well as strengthening maternal and child health services.
24,000 people are directly involved in the project activities, with around 91,000 people reached indirectly.
Obstetric fistula is usually caused by difficult childbirth without medical care and is therefore particularly common in rural areas of Bangladesh. Young women are especially at risk because their bodies may not yet be fully developed for pregnancy and childbirth.
In addition to the profound loss of a child – nine out of ten women affected by fistulas lose their baby during childbirth – women suffer from distressing symptoms such as urinary or faecal incontinence. Improperly performed caesarean sections are also an increasing cause of fistula in Bangladesh.
Many women affected by fistula live in social isolation and poverty. In most cases, these severe injuries can be treated, but many women are unaware that treatment is available or are unable to access a clinic.
Title: Prevention and rehabilitation of obstetric and surgical fistulas through reproductive health education and strengthened health services (PROGRESS)
Local partner: Lutheran Aid to Medicine in Bangladesh (LAMB)
Project region: Rajshahi Division in north-western Bangladesh
Duration: January 2026 to December 2028
Intervention areas: Treatment of obstetric injuries / Strengthening the healthcare system
Our project is being implemented in the rural Rajshahi Division, where many people live in hard-to-reach areas and are affected by poverty. Qualified medical professionals are scarce, and community members with only rudimentary knowledge often take on important healthcare responsibilities. As a result, around one in three women gives birth at home under potentially high-risk conditions.
We strengthen communities and healthcare providers in the prevention and early detection of obstetric fistula and in referring women for treatment by training local healthcare personnel, traditional birth attendants and key community figures on the causes and treatment options for obstetric fistula. Workshops with specialists also improve the quality of surgical procedures, such as caesarean sections, helping to prevent fistulas.
We promote high-quality, individualised care for women with obstetric fistula by identifying those affected at diagnostic camps, referring them to specialized facilities, and training healthcare professionals, so that psychosocial support is provided alongside medical care. We provide close support to particularly vulnerable fistula survivors after surgery and strengthen their economic independence.
We improve the quality of healthcare for women of reproductive age, newborns and children under five by recruiting 10 midwives and 15 healthcare professionals, as well as equipping and, where necessary, renovating existing health centres. We also foster dialogue between government health authorities, clinic management and staff to jointly improve healthcare services.
The project embeds key measures within the public healthcare system, strengthens the capacity of healthcare personnel and improves referral pathways to ensure continuous care for women with obstetric fistula. It promotes collaboration with authorities, community engagement and the social and economic reintegration of fistula survivors. Finally, it strengthens sustainable partnerships and local capacities.
We would like to thank all our funding partners – including those not mentioned here – for making this project possible.
