CONCLUSIONS And RECOMMENDATIONS for the conference titled
Uterine Fibroids: The Science, the Treatment, and the Myths
24-25 March 2022
Summary
The conclusions and recommendations of the Premier African Conference on Uterine Fibroids are based on the recurring priorities identified by participants. The opening remarks, the fifteen (15) presentations from eleven (11) countries- Ghana, Nigeria, Dar es Salaam, Uganda, Egypt, Senegal, Cameroun, Zimbabwe, Congo, USA and Germany and discussions appropriately addressed the conference theme- Uterine Fibroids: The Science, the treatment, and the Myths. Vital conclusions and recommendations emerged at the end of the two-day conference.
Preamble.
- Fibroid Foundation Africa partnered with Campion Fund and Tigovit to organize the meeting. The organizers won plaudits from the participants for such a momentous, thought-provoking meeting which, according to them, is long overdue.
- Clinicians, researchers, policymakers, and survivors from diverse African milieus shared one platform to discuss their country’s perspective on Uterine Fibroids. The researchers shed light on the novel and emerging medical and natural treatment therapies. The policymakers discussed policies on uterine fibroids, and the Survivors shared their journey with fibroids.
- It was such a stimulating, though-provoking two-day session. Day one lasted for about 3 hrs 34 mins and day two for 3hrs 57mins.
- The conclusions and recommendations will be disseminated across all institutions responsible for health in the African Region and other relevant international organizations to seek opportunities for strategic collaboration and funding for studies on Uterine Fibroids in Africa.
- We hope this conference will lay the foundations for an intercontinental network and collaboration for action on Uterine Fibroids in Africa. It will be a platform for the continuous sharing of ideas and experiences and strategic interventions to improve the quality of life for African women living with fibroids. These strategies will include research, education and advocacy programs, early diagnosis interventions, novel management and treatment options, and linkages. The videos on the presentations and conference reports are on the website: www: fibroidfoundationafrica.org
- Conference participants
- Acknowledge that Africa has a high uterine fibroid disease burden.
- The region is endemic.
- Fibroid is understudied
- It is a significant health issue for women and men in the African region
- Under-reported
- 10-20% of cases are symptomatic
- Greater morbidity and high rates of mortality due to fibroids
- Prevalence unknown due to the lack of data
- Tumors are frequent in women in their reproductive ages.
- Tumors are large in young women between the ages of 22-24
- A lot of hysterectomies are carried out, altering the life of young women
- Women present very late to health facilities with huge fibroids
- Delayed diagnosis and treatment
- There is a lack of infrastructure,
- Limited access to care
- Waiting period is extended due to lack of infrastructure
- Women are anemic
- Fear of surgeries
- Lack of care,
- Lack of diagnostic equipment,
- Limited treatment options,
- Accepted and internalized myths hampering treatment-seeking behavior,
- Limited insurance package
- Lack of economic empowerment of women
- Out of pocket payment for surgeries
- Negative social stigma associated with fibroids
- Recourse to traditional medicine
- Lack of education and advocacy programs
Interventions - Research
- Agree that uterine fibroid research is paramount on the African continent
- Research into the pathogenesis of uterine fibroids in Africa
- Data collection and study on prevalence and incidence rate
- Specific Quality of life questionnaire (QoL) translated into various languages to facilitate usage.
- Study on new FDA approved medications
- Study on natural treatment (Vit D, EGCG)
- Study on medical treatment
- Less invasive treatment (Collagenase)
- Study herbal remedies in our milieu
Education, Advocacy, and Communication
- Agree that an effective communication strategy is essential to manage and treat Uterine Fibroids in Africa successfully. Accurate information and increased awareness and knowledge about fibroids can empower women to recognize early warning signs, overcome their fears and misconceptions, and seek medical care promptly.
- Health workforce at all levels to be engaged in education and advocacy programs
- Clinicians at all levels, civil society groups, school health clubs to engage in education and awareness creation programs
- Support groups to be established at all locations
- Patients and clinician voices to be heard
- Radio, TV, social media platforms to be used for awareness creation programs
- The development of effective communication strategy content-verbal and non-verbal
International Co-operation
- Recognize that intercontinental and inter-country collaboration, coordination, and global connectivity are needed to drive uterine fibroids interventions in Africa. Cooperation and networking will create a learning platform, sharing best practices, innovations, and experiences, leading to new opportunities and leveraging novel trends in the care and treatment of uterine fibroid in Africa.
Policy Change
- Advocate for changes in the reproductive health policy and guidelines to include Uterine Fibroids. Inclusion of uterine fibroid as a public health concern in all African countries
- NHIS package to be reviewed to cover the total cost of surgery
- All countries must meet the vision for Universal Health Coverage to provide access to all persons seeking healthcare
Deployment of early diagnostic infrastructure and tools
- Strongly advocate for deploying portable scan equipment in community health facilities for screening, early detection, and prompt management. Early detection is recognized to tie into early treatment.
Prevention and Management
- Recommend daily dose of Vit D supplementation from age 18 to 30. Vit D has been documented as a highly beneficial, inexpensive, readily available preventive intervention against fibroid formation. It has little or no side effects and could help assuage the fibroids burden if supplementation is done early among the at-risk population.
Treatment
- Recommend the broadening of treatment to include laparoscopic surgery, embolization, focused ultrasound as options for making decisions for treatment. These services must be available and accessible to the women of Africa seeking fibroid treatment.