In Afghanistan, maternal and infant mortality rates are among the highest in the world. Many deaths could be prevented, but most families are still without access to basic healthcare, especially those living in rural areas. Midwifery training is key to improving women's access to the healthcare they need, and to improving maternal and infant's health. AfD's Midwifery Program aims at equipping midwives with the necessary skills to reduce maternal and infant mortality.
According to UNICEF, in Afghanistan, infant mortality rate is 52 deaths per 1,000 live births and maternal mortality rate is 638 deaths per 100,000 live births. Only 51% of births are attended by skilled health personnel. Long distances to health facilities and lack of female medical personnel are amongst the main concerns regarding women's access to healthcare. Rural areas face a shortage of midwives and female health professionals, although they account for most pregnancies and deliveries.
AfD plans on training 400 midwives across 4 provinces of Afghanistan: Kabul, Logar, Wardak and Badakhshan. Following a "skills-gap protocol", AfD delivers training to 80 government-trained community midwives, who will then become trainers. They would then return to their local/rural communities and deliver the training to an additional 4 midwives each, through a 'cascade-model' approach. Between 2014 and 2019, AfD has already trained more than 600 midwives in 6 provinces across Afghanistan.
The 'cascade-model approach' has proven more effective, less expensive, more sustainable and community-based than traditional training methods. After the training, the midwives will be able to better perform their roles in the healthcare system, contribute to the prevention of preventable maternal and infant mortality, improve women and children's access to health services while, at the same time, improve women's participation in the workforce.