CONTINENCE MANAGEMENT
Saving Lives! improving Futures (SLIF) Project !!
Incontinence means when a person has no control over bowel and bladder function. There is inability to pass urine and/or feces in a socially acceptable and hygienic way.
All children born with spina bifida will have a neuropathic (nerve damaged) bladder and bowel. With no continence intervention, a significant proportion of children with spina bifida will experience kidney problems, which without treatment would result in renal failure. Most will wet and soil every day. In the absence of good quality, highly absorbent disposable nappies or pads, skin soreness is hard to avoid. For some, the sores will develop into deep wounds that are almost impossible to heal.
In developing countries like Nigeria, the situation is compounded by high level of poverty, profound cultural and spiritual stigmas attached to medical issues of this nature, paucity of medical equipment and personnel.
Any person living with incontinence is psychologically affected by it; self-esteem is low, educational opportunities are reduced and employment is difficult to obtain. Relationships between family and friends are hard to maintain.
Four areas of continence management:
Clean Intermittent catheterisation – CIC – to drain the bladder on a regular basis to reduce the risk of Urinary Tract Infection and kidney damage.
Bowel washouts – to evacuate the faeces daily to prevent soiling, and to avoid build-up of stool in the lower bowel which can impact on the health of the bladder.
Measuring bladder pressure – monitoring the pressure within the child’s bladder is used to document the behaviour of the bladder and allows the success of the treatment to be measured.
Instillation of Oxybutynin – anticholinergic medicine to reduce bladder overactivity by relaxing the bladder muscles. This reduces wetting and preserves renal function.
Since 2017, FFF has worked with its UK partner – Shine UK with funding from Hub Cymru Africa (Wales for Africa Hub) to save lives through promotion of continence among children with spina bifida hydrocephalus thus eliminating social isolation, preserve renal function and improve overall quality of life. Affected children identify this program as the changing point in their lives, enabling their full integration and participation in society. From the just ended grant cycle of 2022/2023, the following achievements were recorded.
- Partnership and establishment of 6 public healthcare facilities namely Lagos University Teaching Hospital (LUTH), Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), University College Hospital Ibadan (UCH), Rivers State University Teaching Hospital (RSUTH), University of Benin Teaching Hospital (UBTH) and University of Abuja Teaching Hospital (UATH) in south-west, north-central and south-south Nigeria.
- Regular supply of vital continence equipment to six public health facilities for pro bono use by babies, children, and youngsters with spina bifida and hydrocephalus.
- Improved health and quality of life for 155 babies, children, and young adults with spina bifida and hydrocephalus through access to comprehensive continence management and care.
- Engagement of 200 parents and other family members in continence management knowledge thus enhancing care support to their children.
- Linkage between Wales (United Kingdom) and Africa (Nigeria) established as a result of regular communication and planning meetings established. As well as exchange of knowledge and best practice between healthcare professionals in Wales and those in Nigeria.
- 60 healthcare professionals (nurses) have gained knowledge in continence care and management and have improved capacity to manage incontinence in children with spina bifida and hydrocephalus.
- Development of disability-inclusive data collation collection tools and adoption by all the partnering hospital facilities to ensure monitoring of progress in individual patients as well as facility activities.
- Peer learning and mentoring between teenagers and young people from Wales and Nigeria providing an opportunity to share experiences, talk about hopes for the future and what living with Spina Bifida meant to them.
- Virtual training on covid-19 knowledge and preventive skills: Training was used to strengthen healthcare professionals on effective communication with patients to address misinformation amidst covid-19 vaccination.
- Continence management training for 60 healthcare professionals in public health care facilities across three of the regions mentioned above.
- On-site practical demonstrations on continence care and management within the premises of partnering public healthcare facilities.
- Quarterly continence working group of healthcare practitioners in Wales and Nigeria for knowledge sharing, learning and promotion of best practices.
- Establishment of FFF continence clinic as back-up to partnering public health facilities.