{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T19:57:08Z","timestamp":1781294228597,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Surgery for obstetric fistula is a highly effective treatment to restore continence and improve quality of life. However, a lack of data on the cost\u2010effectiveness of this procedure limits prioritization of this essential treatment. This study measures the effectiveness of fistula surgeries using disability\u2010adjusted life years (DALYs) averted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 2021 and 2022, the Fistula Foundation funded 20\u2009179 fistula surgeries and related procedures at 143 hospitals among 27 countries. We calculated DALYs averted specifically for vesicovaginal fistula and rectovaginal fistula procedure types (<jats:italic>n<\/jats:italic>\u2009=\u200913\u2009235 surgeries) by using disability weights from the 2019 Global Burden of Disease study. We based cost calculations on direct treatment expenses, including medical supplies, health provider fees, and preoperative and postoperative care. We measured effectiveness using data on the risk of permanent disability, country\u2010specific average life spans, and treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total treatment cost was $7.6 million, and a total of 131\u2009433 DALYs were averted. Thus, the cost per DALY averted\u2014the cost to restore 1\u2009year of healthy life\u2014was $58. For this analysis, we took a cautious approach and weighted only surgeries that resulted in a closed fistula with restored continence. We calculated DALYs averted by country. Limitations of the study include data entry errors inherent in patient logs and lack of long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current study demonstrates that obstetric fistula surgery, along with having a significant positive impact on maternal health outcomes, is highly cost\u2010effective in comparison with other interventions. The study therefore highlights the benefits of prioritizing fistula treatment as part of the global agenda for maternal health care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15502","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T16:09:10Z","timestamp":1712074150000},"page":"480-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Measuring the cost\u2010effectiveness of treating rectovaginal and vesicovaginal fistulas: A multicenter global study by the Fistula Foundation"],"prefix":"10.1002","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9394-8877","authenticated-orcid":false,"given":"Keerthana","family":"Rajagopal","sequence":"first","affiliation":[{"name":"Fistula Foundation  San Jose California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Pollaczek","sequence":"additional","affiliation":[{"name":"Fistula Foundation  San Jose California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Chu","sequence":"additional","affiliation":[{"name":"Fistula Foundation  San Jose California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Mann","sequence":"additional","affiliation":[{"name":"Fistula Foundation  San Jose California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-07351-x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.06.032"},{"key":"e_1_2_11_4_1","unstructured":"World Health Organization.Guiding principles for Clinical Management and Programme Development.2006."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12893"},{"key":"e_1_2_11_6_1","volume-title":"Obstetric Fistula","author":"World Health Organization","year":"2018"},{"key":"e_1_2_11_7_1","volume-title":"Where We Work","author":"Fistula Foundation","year":"2024"},{"key":"e_1_2_11_8_1","volume-title":"What We Do","author":"Fistula Foundation","year":"2024"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czy078"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0168512"},{"key":"e_1_2_11_11_1","unstructured":"Disease Control Priorities.Disease Control Priorities. n.d. 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