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.
Jan 3, 2012

A Family's Loss Inspires A Career in Midwifery

Sedeqa Khavari - photo by M. Hassan Zakizadeh
Sedeqa Khavari - photo by M. Hassan Zakizadeh

Kabul, Afghanistan – Her older sister died while giving birth to her niece, and now Sedeqa Khavari feared her pregnant, younger sister, Masoma, would suffer the same fate. 

Masoma had become seriously ill from hypertension, and a visit to the hospital offered no relief. After returning home, the expectant mother suffered convulsions and fell unconscious. The family rushed Masoma back to the hospital, where her premature baby was delivered by cesarean section and the young mother survived.  

The experience left a lasting impression on Sedeqa and set her on a new path.

“I will never forget [that night],” says Sedeqa. “My sister was near death. I decided I have to learn more about midwifery and this way I can help all mothers in Afghanistan.”

Sedeqa followed through on her decision. In 2007, she graduated from a government-sponsored midwifery school in Bamyan Province, one of 13 across Afghanistan supported by the Jhpiego-led Health Services Support Project (HSSP). Since 2002, when Jhpiego helped develop and rebuild a national midwifery education system in Afghanistan, more than 3,000 new midwives have graduated from accredited schools, many of them returning to their communities to care for women and their families. 

Sedeqa worked for two years as a community midwife and then left her home province of Bamyan in north central Afghanistan to work in Kabul at the Cure Hospital, a private health facility that employs several graduates of the HSSP-supported schools. 

Working as a midwife, this 28-year-old, single mother is able to provide for her son and contribute to the improved health of mothers and newborns in her country. She says Afghanistan needs more midwives like her. “We should think about increasing the number of midwives, especially in remote areas,” says Sedeqa, after talking about her older sister, who lived and died in mountainous Ghor Province, where transportation to adequate health care is difficult. “If we continue our training and get new training, health care services would be better for mothers.” 

Sitting in a small office outside the maternity ward at Cure Hospital, Midwife Supervisor Fahima Naziri is awaiting lab results for a 35-year-old woman in labor. The woman, who is carrying a big baby in a breech position, may well be suffering from pre-eclampsia, a high blood pressure disorder that can rapidly escalate into the more dangerous eclampsia. 

Based on her training, Fahima predicts her patient will need a cesarean section, but the woman’s husband is opposed. “We are checking the baby’s fetal heart rate and the contractions,’’ says the 26-year-old midwife. “We are also checking the blood pressure. When the lab results return, we will decide whether to give her magnesium sulfate [the prescribed treatment for pre-eclampsia].” 

In an effort to get the woman the care she needs, Fahima seeks the assistance of a colleague, a male doctor who meets with the husband and explains the situation: Do you want your wife to live? 

The husband reluctantly agrees to the operation, recognizing that without his wife there will be no more children. Despite seven pregnancies, the couple has only two children. The nurse-in-charge, Jennifer Housand, explains that in the maternity ward, “Unfortunately, the woman has no say. The husband decides.”

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Oct 17, 2011

Young Midwife Takes Charge, Saves A Life

A Young Midwife, Shahrbanoo
A Young Midwife, Shahrbanoo

She is little more than a girl, but on this day in the village of Shahidan, Shahrbanoo proves to be a woman of confidence, conviction and capability. While surveying the maternal health of the community, the young midwife knocks on the door of a small house where she knows a pregnant woman has given birth.

How is the mother, Shahrbanoo asks. The man at the door refuses to let her in.

Backing away, Shahrbanoo moves onto the next house. But when her survey work is done, the Jhpiego-trained midwife returns to the house where she has been turned away. She knocks firmly: I am a midwife. I am here to help.

The man resists, is skeptical that this young girl who has neither medicines nor any tools can help his wife. He has given up hope.

Shahrbanoo insists that she enter. This time, the man relents.

Inside, the wife, a mother of six, is still bleeding after giving birth. Shahrbanoo examines her. The mother is likely to bleed to death if the placenta isn’t removed. There isn’t enough time to get her to a health facility. Shahrbanoo finds a plastic bag to protect herself, uses it as a glove and, with the skills she has learned in midwifery school, reaches in and removes the retained placenta, gently massages the uterus. The bleeding stops.

This is the first life this young midwife has saved, and with confidence and resolve she is ready to save even more lives. 

Shahrbanoo graduated as a midwife from the Bamyan midwifery school six months ago. Jhpiego has led the reestablishment of midwifery education in Afghanistan since 2002.

Jul 21, 2011

A Voice for Afghan Women & Midwives

Mozghan Mohammadzai, AMA Vice President
Mozghan Mohammadzai, AMA Vice President

During the recent International Congress of Midwives in Durban, South Africa, one of the key messages was midwives do so much more than deliver babies. Mozhgan Mohammadzai, of Afghanistan, is a prime example. Educated through the Jhpiego-supported national midwifery program, Mozhgan has helped deliver more than a  1,000 babies. Today, as a leader in the Afghan Midwives Association (AMA), the 23-year-old is focused on building the ranks of her profession and developing women leaders across her country. 

From the time she took her first job as a midwife at a
hospital in Herat, Afghanistan, Mozhgan took great pride in helping
women who previously gave birth without a skilled birth attendant at their
side. Living in a rented room near the Gulran District Hospital, the 2005
graduate of the Health Science Institute of Herat spent two years filling a
void in a place where there were previously no female physicians or midwives.

“Working with women and saving mothers’ lives gave me a special feeling,
which I never felt before, and made me more confident that I made the right
decision to become a midwife,” says Mozhgan, AMA vice president.

After her two years in Gulran, she went to work for the Afghan
Midwives Association (AMA) as a provincial representative, and joined the staff
of the regional maternity hospital in Herat City as the head midwife. Since 2009,  Mozhgan, whose family
includes many women who are physicians and teachers, has worked as a program
officer with Jhpiego’s midwifery education program in Kabul. Convincing
her relatives to allow her to move far from home was not easy—it remains culturally
unacceptable for a young woman to strike out on her own. 

 But she says it was worth the struggle: “I’m proud of my
profession and it feels good working for mothers and midwives through Jhpiego
and the AMA.”