Jhpiego

For almost 40 years and in over 150 countries Jhpiego has worked to prevent the needless death of women and their families. Jhpiego,an affiliate of Johns Hopkins University designs innovative, effective and low-cost solutions to ensure high-quality health care for the worlds most vulnerable populations. Working in HIV/AIDS, family planning and reproductive health, maternal and newborn health care, infection prevention and control and malaria - Jhpiego helps countries care for themselves.
Feb 19, 2014

Jhpiego Global Giving Report - First Quarter 2014

Afghan Health Providers’ Response to a Leading Cause of Deaths in Pregnant Women

A leading cause of women dying in childbirth in the developing world is a pregnancy-related blood pressure condition known as pre-eclampsia/eclampsia. Symptoms of the potentially life-threatening condition of pre-eclampsia are elevated levels of protein in a pregnant woman’s urine and high blood pressure after 20 weeks. If undiagnosed and unmanaged, pre-eclampsia can rapidly progress to eclampsia (convulsions/fits)—the deadliest form of the condition. In Afghanistan, health statistics show that 20 percent of maternal deaths are the result of hypertensive conditions.

Midwives in Afghanistan who have been trained by Jhpiego have learned to screen for pre-eclampsia/eclampsia during prenatal visits and treat it appropriately. In an effort to ensure that Afghan midwives and their physician colleagues are delivering appropriate care, Jhpiego did an analysis of health care facilities that provide emergency obstetric and newborn care and their response to pre-eclampsia/eclampsia. Jhpiego-supported staff interviewed 224 health care providers at 78 facilities and found that all of the facilities had the proper equipment—blood pressure cuffs and stethoscopes—and three-fifths had urine test strips to check for high levels of protein in a pregnant woman’s urine. In addition, from 76.7 percent to 96 percent of these facilities had a complete IV set to maintain fluid balance and administer antihypertensives and magnesium sulfate, which has been shown to reduce the risk of death from eclampsia by 45 percent.

As to the competency of health care providers, the analysis showed that 96 percent of doctors and 89 percent of midwives recognized that magnesium sulfate should be used to manage severe pre-eclampsia/eclampsia, but 42 percent of doctors and 58 percent of midwives also thought another drug, diazepam, had a role to play in treating these women. Diazepam is recommended when magnesium sulfate is not available. While supplies of anticonvulsant drugs were available at the facilities, the drugs weren’t always used, according to the analysis.

These findings suggest a need to clarify service delivery guidelines, offer refresher training and bolster best practices with supervision and reinforcement for health care providers, especially for those working in facilities with fewer women presenting with symptoms of pre-eclampsia/eclampsia.

According to the journal article on the analysis results mentioned above, “The study findings will be used to help inform continuing education and reinforcement efforts in Afghanistan and also to standardize supplies and equipment across different facility levels. More broadly, they can contribute to the development of effective strategies for translating health worker knowledge into practice in low-income countries.”

Nov 18, 2013

Keeping Mothers and Babies Alive

Community midwifery students in Afghanistan
Community midwifery students in Afghanistan

 

As we come to the end of another successful year we wanted to take a moment to say THANK YOU to all of you who have helped us to save the lives of women and babies in Afghanistan through our project Educate a Midwife – Save Women in Afghanistan

Because of donors like you, Jhpiego has supported midwifery training programs across Afghanistan and helped to ensure that more mothers are alive today caring for their children and families. 

We also wanted to remind you of the many ways your donations have made an impact.  Since Jhpiego began working in Afghanistan:

The percentage of women giving birth in health facilities has increased from 19% to 32.4%.

Community health workers have educated more than 1,000 pregnant women living in remote areas on how to use misoprostol – a lifesaving drug that prevents mothers from bleeding to death after birth.

Mothers are surviving!  There has been a significant drop in maternal deaths across the country – from 1,400 for every 100,000 live births to 327 for every 100,000 live births.

And while there is still much work to be done, we have people like you to thank for the remarkable progress we have made so far. 

So, again and with all our hearts, THANK YOU!  You are helping to keep mothers and babies alive and families together through your kindness.      

Aug 19, 2013

Saving Mothers in Afghanistan

Marzia
Marzia

Mothers in Afghanistan are alive today because of women like Marzia Resolu…

Marzia is among the 3,000 midwives who have been educated and trained through the national midwifery education system established by the government of Afghanistan with support from U.S. Agency for
International Development (USAID) and Jhpiego. 


During the years of Taliban rule, maternal mortality in Afghanistan was the second highest in the world, and women routinely died in pregnancy and childbirth.  Maternal and newborn services and skilled care were nearly non-existent.  The consequences for the women of Afghanistan were significant. The presence of a skilled health care
provider during birth is the single most important intervention to keep a pregnant woman and her newborn alive and healthy.

With community midwifery schools re-established and skilled midwives returning to the workforce, Afghanistan’s maternal death rate has declined significantly. 

“Previously there was no midwife in our village and women were suffering bleeding and their children were dying. Now, thanks to God, we have got a midwife and since have not seen a pregnancy death.”

A Jhpiego-supported study found that the numbers of women receiving prenatal care services was greater in provinces that had community midwifery schools than in those without them. In those same provinces, more women gave birth in a health facility where complications could be addressed swiftly and properly.


“People in the village are happy with them since they are female, because we cannot talk to male doctors about our problem. If we go and see a male doctor, our men will kill us. These midwives are everything for us.”     

A teacher, Marzia returned to school at age 26 to become a skilled midwife.  Marzia, and others like her, will go to great lengths to ensure their patients receive the care they need – these midwives often walk or travel by donkey for hours to make home visits, working nights and long hours.   

“I know that there is a great need for midwives in the region as many women have problems in childbirth because there are very few facilities and the insecurity makes it very hard for people to travel to hospital when they need to,” said Marzia. “I am very happy that I will be able to go back to my community . . . and help my people.

The demand for skilled midwives, however, remains high. An additional 5,000 educated and trained midwives are needed to ensure women living across this mountainous and rugged country receive the skilled care they need to survive childbirth. As international funding has declined, community midwifery schools have closed. When the Jhpiego-led Health Services Support Project ended in the fall of 2012, there were 32 schools. That number has since dropped to 22.

Continued strengthening of midwifery education and training in Afghanistan is essential to saving the lives of women and newborns in this country.  Your support has made a great impact on the lives of women and their babies throughout Afghanistan.  Working together, we will save the lives of many, many more.         

Source material: EVALUATION OF
THE PRE-SERVICE MIDWIFERY EDUCATION PROGRAM IN AFGHANISTAN, March 2011, Health Services Support Project (HSSP)