Women's Genital Prolapse and Incontinence (Gondar, Ethiopia)
About this PSP
The Gondar Priority Setting Partnership (PSP) is an initiative between the University of Gondar, College of Medicine; the Department of Health Sciences, University of Leicester; and the College of Medicine and Health, University of Exeter. The three universities are developing a research programme to study the epidemiology and impact of pelvic organ prolapse (POP) and urinary incontinence (UI) among women living in Northern Ethiopia and to develop and evaluate conservative and surgical interventions for women which can be effectively delivered in community-based health care.
Given the challenges facing health services in Ethiopia and other low and middle income countries, and the importance of providing healthcare that is holistic and grounded in the needs and preferences of the community, it is imperative to explore the treatment uncertainties and concerns of women and other stakeholders. Working with the James Lind Alliance, this PSP has the objective of identifying these uncertainties in partnership with women, their families and communities and professional stakeholder groups.
The PSP is funded by Wellcome.
Impact of Top 10s
Who is involved
The steering group
Patient and carer representatives:
Abrhet Gebreegziabher (Patient representing those who have/had urinary incontinence)
Elsa Weldegebrhana (Carer of patient with incontinence)
Yisaem Bezae (patient representing those who have/had pelvic organ prolapse)
Ambaye Dejen Tilahun (Carer of patient with pelvic organ prolapsed)
Clinical representatives:
Dr Ambaye Wolde Michael, Obstetrician and Gynaecologist and representative of Women and Health Alliance International (WAHA)
Tewodros Meheret Fetene, Gondar physiotherapist
Workae Ejgu, Gondar nurse
NGOs working on pelvic floor disorders:
Wagaye Fentahun (UNFPA)
Hawlt Abeyu Ejigu (Simien Mountains Mobile medical service)
The management team
Toto Anne Gronlund, JLA Adviser
Contact for more information
Prof Doug Tincello
Dr Zelalem Mengistu: È + 251 936380001 zelalem.mengistu@uog.edu.et
Toto Anne Gronlund: Toto.jla@microwells.uk
The image below shows the PSP steering group.
Why is this important
Although much is known about the causes, impact and treatment of pelvic floor disorders, this research has generally come from more economically developed countries, and there is far less published information from low and middle income countries (LMIC).
Two recent studies in Ethiopia report prevalence for women experience symptoms of any pelvic floor disorders of 12% and 20% 1,2. Despite a majority of women in this Eastern Ethiopian population reporting symptoms of UI and POP to be severely distressing only a third of women had sought help. This is despite growing evidence that UI and POP have significant negative impacts on these women’s lives, affecting daily activities and social roles and personal and sexual relationships. UI and POP are often perceived as an inevitable part of aging or result of childbirth and women “silently wait to heal” as reported in a qualitative study from North West Ethiopia 3,4.
There has been work to raise awareness of symptoms and encourage women to seek help. However, the lack of accessible and effective care pathways for women in LMICs must also be addressed. Access to surgical treatment is very limited given the number of available qualified health professionals and geographical and financial barriers for women 5. Yet evidence from other countries suggests that non-surgical treatment may be effective for a large proportion of women.