title: Urogenital fistula reviewed: a marker of severe maternal morbidity and an indicator of the quality of maternal healthcare delivery.
abstract: BACKGROUND
  While obstetric fistula has been recognized as a major maternal morbidity since the 1980s, it has become an indicator of access to and quality of women' s health care.
  
  
  RESULTS
  Obstetric fistula still exists in low-income countries (LIC) because health care systems fail to provide adequate family planning, skilled birth attendance, basic and emergency obstetric care, and affordable treatment of fistula, while concurrently lacking social networks to serve as safety nets for affected girls and women [WHO, 2007].
  
  
  CONCLUSIONS
  This review explores the most recent published experience with respect to the definition of fistula, its diagnosis, treatment, and management, and further steps for prevention of fistula on a global scale.
authors.affiliation: Department of Obstetrics/Gynecology, Columbia University, New York, NY USA.
authors.forename: Margo S
authors.initials: MS
authors.lastname: Harrison
authors.affiliation: Moi University School of Medicine, Eldoret, Kenya.
authors.forename: Hillary
authors.initials: H
authors.lastname: Mabeya
authors.affiliation: Department of Obstetrics/Gynecology, Columbia University, New York, NY USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
authors.affiliation: RTI International, Durham, NC USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: McClure
keywords: Low and middle income countries; Maternal morbidity; Obstetric fistula; Urogenital fistula