New research finds obstetric fistula surgery achieves high impact at low cost
New peer-reviewed research conducted by the US-based Fistula Foundation, has highlighted just how far each pound invested in tackling obstetric fistula goes in improving the quality of a woman’s life.
The Fistula Foundation analysed the cost-effectiveness of fistula repair surgery across 143 hospital sites in 27 countries, including Ethiopia. They found fistula surgery has a cost per disability adjusted life year averted of US$ 58 – highlighting the enormous value of investing in fistula surgery on a woman’s life.

Disability Adjusted Life Years are a time-based measure that combine years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health or disabililty, to assess the relative burden of a health condition.
When assessing the impact of fistula repair surgery, the relevant metric is DALYs averted—the number of years of healthy life that the intervention will save or restore. The Fistula Foundation highlight in their research “Quantifying impact in this way enables researchers to assess the improvement in quality of life per dollar spent on the intervention”. The lower the cost to avert a single DALY, the more cost-effective an intervention is.
The Fistula Foundation have also found the results compare positively with those of studies using the same methodology to other health interventions. For example, a study of Operation Rainbow, an American organisation that provides orthopaedic surgeries to children, resulted in a cost per DALY averted of US$ 343.
Kate Grant, CEO of Fistula Foundation said
“We already know that fistula surgery is one of the best bargains in the field of global health…with this newly released study, we now have precise data on the incredible ‘bang for the buck’”.
Kate Grant, CEO, Fistula Foundation
Footnotes:
- Read more about Disability Adjusted Life Years on the World Health Organisation website.


