This manual is intended to be a practical guide to be read and used at many different levels by many different people, especially health-care professionals and planners, policy-makers and community leaders. Its three main objectives illuminate its wide reach and potential utility. First of all, it strives to draw attention to the urgent issue of obstetric fistula and advocates for change. Secondly, it provides essential, factual background information along with principles for developing fistula prevention and treatment strategies and programs. Finally, it endeavors to contribute to the development of more effective services for women under treatment for fistula repair.