{ "version": "0.1", "id": "fistula-foundation-repair", "name": "Fistula repair with Fistula Foundation", "checkedOn": "2026-10-12", "costBasis": "USD received by Fistula Foundation, provisionally mapped to future delivery using a rounded organization-wide expense allowance per procedure; not a verified marginal cost or full societal cost.", "sourceFacts": { "reportedDirectPatientCostUSD": 624, "reportedDirectPatientCostIncludes": [ "surgery", "postoperative care", "physical rehabilitation" ], "totalExpenses2025USD": 24023353, "programExpenses2025USD": 20604972, "managementExpenses2025USD": 1533442, "fundraisingExpenses2025USD": 1884939, "surgeries2025": 19577, "reportedPerinealTearCaseShare": 0.2, "clinicalCohortBaselineN": 60, "clinicalCohort12MonthN": 58, "clinicalCohortNoUrinaryIncontinence3Months": 0.61, "clinicalCohortNoUrinaryIncontinence12Months": 0.672 }, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "fistulaShare": 0.8, "creditedDays": 275, "creditedWindow": "Postoperative days 91 through 365 inclusive. No early or later benefit credit; perioperative harms remain unestimated.", "fistulaShareBasis": "WSI approximation from the reported 20% perineal-tear share. Assumes the remaining 80% is eligible fistula care; future mix is unverified. Tear-repair benefits remain outside this model.", "intensityBasis": "A single average reduction across physical and emotional suffering. WSI judgment, not a conversion from disability weights, depression scores or a measured USU survey. Averages include sleep and periods of relief.", "additionalCourseBasis": "WSI assumption about the share translating into distinct additional treatment courses that otherwise would not occur within the credited year. Allows for repeat procedures, other funding and delayed allocation. This is not a measured causal effect.", "lastingReliefBasis": "Provisional proxy informed by one small Ugandan follow-up cohort. Continence does not establish freedom from suffering. The chosen intensity reduction allows residual distress; partial relief in other courses is unestimated." }, "scenarios": { "lower": { "label": "Lower", "costPerProcedureUSD": 2000, "additionalCourseShare": 0.5, "lastingReliefShare": 0.5, "averageIntensityReduction": 1 }, "central": { "label": "Central", "costPerProcedureUSD": 1500, "additionalCourseShare": 0.75, "lastingReliefShare": 0.65, "averageIntensityReduction": 2 }, "higher": { "label": "Higher", "costPerProcedureUSD": 1000, "additionalCourseShare": 1, "lastingReliefShare": 0.8, "averageIntensityReduction": 3 } }, "fundingSnapshot": { "status": "donations_accepted_gap_unverified", "checkedOn": "2026-10-12", "remainingFundingGapUSD": null, "verifiedMarginalCostUSD": null, "nextCampaign": null, "basis": "Official general donation page and September 2026 Uganda network announcement. Active operations and expansion do not establish an unfilled budget or the allocation of a new gift.", "recheckDue": "2026-11-11" }, "donationURL": "https://fistulafoundation.org/donate/", "sources": [ { "id": "F1", "title": "Fistula Foundation: FAQs", "url": "https://fistulafoundation.org/about/faqs/", "locator": "How much does it cost to treat obstetric fistula?; Can perineal tears be treated?", "role": "Reported direct cost and approximate case mix", "checkedOn": "2026-10-12" }, { "id": "F2", "title": "Fistula Foundation: 2025 audited financial statements", "url": "https://fistulafoundation.org/wp-content/uploads/2019/03/Fistula-2025-Audited-Statements.pdf", "locator": "Statements of Activities, printed page 3 (PDF page 6), 2025 total expenses", "role": "Organization-wide expense context; not a marginal-cost estimate", "checkedOn": "2026-10-12" }, { "id": "F3", "title": "Fistula Foundation: 2025 results", "url": "https://fistulafoundation.org/news/advances-womens-global-health/", "publishedOn": "2026-03-26", "role": "Reported annual surgical volume, including related childbirth injuries", "checkedOn": "2026-10-12" }, { "id": "F4", "title": "El Ayadi et al. (2019): Trajectories of physical and psychosocial health after fistula repair", "url": "https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.13178", "doi": "10.1111/tmi.13178", "locator": "Table 2 and discussion; 60-woman Ugandan longitudinal cohort", "role": "One-year outcome context, not a controlled donation-impact study or a current portfolio average", "checkedOn": "2026-10-12" }, { "id": "F5", "title": "Fistula Foundation: Uganda treatment network launch", "url": "https://fistulafoundation.org/news/fistula-treatment-network-uganda/", "publishedOn": "2026-09-03", "role": "Current program activity; not proof of a remaining funding gap", "checkedOn": "2026-10-12" } ], "interpretation": "Gross later relief within the first postoperative year. All future cost, attribution, outcome and intensity factors are provisional WSI assumptions. Results are illustrative scenarios, not confidence intervals, a verified donation return, a complete net-benefit estimate or a lower bound. Actual additional benefit can be zero. Different scope and horizon from the AMF analysis; no charity ranking follows.", "exclusions": [ "suffering during the first 90 days, including surgical recovery", "surgical complications and other adverse effects", "benefits after the first postoperative year", "partial benefits in courses outside the lasting-relief fraction", "severe perineal-tear repair benefits", "deaths prevented", "income and caregiver effects", "bereavement" ], "calculation": { "modelVersion": "0.1", "checkedOn": "2026-10-12", "budgetUSD": 1000, "costBasis": "USD received by Fistula Foundation, provisionally mapped to future delivery using a rounded organization-wide expense allowance per procedure; not a verified marginal cost or full societal cost.", "historicalExpensePerProcedureUSD": 1227.1212647494508, "sharedAssumptions": { "referenceIntensityHours": 47.25, "intensityExponent": 1, "fistulaShare": 0.8, "creditedDays": 275, "creditedWindow": "Postoperative days 91 through 365 inclusive. No early or later benefit credit; perioperative harms remain unestimated.", "fistulaShareBasis": "WSI approximation from the reported 20% perineal-tear share. Assumes the remaining 80% is eligible fistula care; future mix is unverified. Tear-repair benefits remain outside this model.", "intensityBasis": "A single average reduction across physical and emotional suffering. WSI judgment, not a conversion from disability weights, depression scores or a measured USU survey. Averages include sleep and periods of relief.", "additionalCourseBasis": "WSI assumption about the share translating into distinct additional treatment courses that otherwise would not occur within the credited year. Allows for repeat procedures, other funding and delayed allocation. This is not a measured causal effect.", "lastingReliefBasis": "Provisional proxy informed by one small Ugandan follow-up cohort. Continence does not establish freedom from suffering. The chosen intensity reduction allows residual distress; partial relief in other courses is unestimated." }, "scenarios": { "lower": { "label": "Lower", "costPerProcedureUSD": 2000, "additionalCourseShare": 0.5, "lastingReliefShare": 0.5, "averageIntensityReduction": 1, "supportedProcedureEquivalents": 0.5, "additionalTreatmentCourses": 0.2, "coursesWithLastingRelief": 0.1, "reliefDays": 27.5, "usuAverted": 13.968253968253968, "directDeathsPrevented": null }, "central": { "label": "Central", "costPerProcedureUSD": 1500, "additionalCourseShare": 0.75, "lastingReliefShare": 0.65, "averageIntensityReduction": 2, "supportedProcedureEquivalents": 0.6666666666666666, "additionalTreatmentCourses": 0.4, "coursesWithLastingRelief": 0.26, "reliefDays": 71.5, "usuAverted": 72.63492063492063, "directDeathsPrevented": null }, "higher": { "label": "Higher", "costPerProcedureUSD": 1000, "additionalCourseShare": 1, "lastingReliefShare": 0.8, "averageIntensityReduction": 3, "supportedProcedureEquivalents": 1.0, "additionalTreatmentCourses": 0.8, "coursesWithLastingRelief": 0.6400000000000001, "reliefDays": 176.00000000000003, "usuAverted": 268.19047619047626, "directDeathsPrevented": null } }, "interpretation": "Gross later relief within the first postoperative year. All future cost, attribution, outcome and intensity factors are provisional WSI assumptions. Results are illustrative scenarios, not confidence intervals, a verified donation return, a complete net-benefit estimate or a lower bound. Actual additional benefit can be zero. Different scope and horizon from the AMF analysis; no charity ranking follows." } }