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Training Midwives in Afghanistan

by Action for Development (AfD)
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan
Training Midwives in Afghanistan

Dear Supporter,

During this difficult time, we hope you are safe and healthy, as well as your family and your loves ones.

For the year 2019, the Midwifery Training Program was implemented in the Province of Kapisa, during the month of December. Kapisa was selected for the initial training of midwives due to its acceptable level of security and infrastructures (training center, hospitals for practice, accommodation, etc.), as well as its adequate transport network which is essential for the training. For the development of the training modules we have partnered with the Haute Ecole de Santé de Genève; the midwifery department has kindly shared its pedagogical skills and clinical expertise.

The training was carried out in two phases: during the first phase, 21 graduate midwives have received the training, after being selected according to pre-established criteria. During the second phase, they themselves have had the opportunity to train other midwives, nurses and medical staff members.

AfD has adopted a “cascade-model” approach as the best strategy to provide training aimed at improving and developing midwifery knowledge; through this approach, a total of 119 midwives received quality training during the reporting period.

AfD’s local office in Kabul has collaborated with community leaders, whose constant support for this program is essential due to the significant influence they exert on their communities. The Ministry of Public Health, as well as local and international NGOs in charge of health facilities, had the responsibility of selecting midwives, through an interview and a theoretical examination. The tests have been designed by AfD’s master trainer recruited for the program.

Phase I of the training was conducted over 10 days at a training center, one week consisting of theoretical classes from 9 a.m. to 3 p.m. An examination was carried out beforehand to test the skills of the participants. Phase II of the training took place over two days, at the Kapisa Provincial Hospital, where midwives were trained on practical skills. 

Following the training, the midwives returned to their locations in order for them to train up to 8 colleagues each. The midwife in charge of the training has divided the lessons into 5 sessions over a period of one month. AfD’s master trainer has attended some of the lessons given in various health centers across the province in order to assist the midwives, both teachers and students.

The 21 midwives who benefited from the initial training have all been provided full accommodation at a common facility in Kapisa during the training period, in addition to covering transport costs throughout the duration of the program. The total 119 midwives (from phases I and II), also continued receiving their salary during the duration of the program. An agreement had been previously reached with their employer, namely the NGO responsible for managing the health facilities where the midwives were employed.

Action for Development would like to thank our donor community, whose kind donations have allowed us to successfully implement the Midwifery Training Program in Afghanistan throughout these years. We look forward towards implementing the project in 2020 and continuing to support the people of Afghanistan!

Sincerely,

The Team at AfD



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Action for Development has provided quality training to midwives in Afghanistan since 2014. The training modules are developed by Action for Development in collaboration with the Haute Ecole de Sante de Geneve – Departement de Sages-Femmes (Geneva Health School – Midwifery department); modules include: care of the newborn, eclampsia, pre-eclampsia, management of 3rdstage of labour and postpartum haemorrhage.

Each training program is provided over a period of about 2 weeks at a training centre located in the province. It involves both classroom-based learning and practical clinical experience; at the end of the training, midwifes sit an exam and receive a certificate recognized by the Ministry of Public Health of Afghanistan. 

From the 7th to the 13th of December 2019, AfD provided training to 20 midwives selected in the province of Kapisa; following our cascade-model approach, these midwives will train an additional number of midwives in their communities, for an estimated total of 100 midwives trained in the province by the end of the year. The training included a two-day residency at the provincial hospital of Kapisa and it was officially recognized by the Ministry of Public Health.

On behalf of Action for Development, we would like to express our gratitude to our donors for their continued support, which makes the midwifery project possible. Action for Development intends on extending its programs throughout 2020 with the intent of supporting the most vulnerable communities of Afghanistan to achieve our vision of "healthy families, empowered communities".

With our warmest regards,

The Team at AfD

 

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Afghanistan has one of the world’s highest maternal mortality rates (UNICEF).  At present, it is estimated that there are 396 deaths per 100,000 live births (MSF).  Although maternal and neonatal deaths are steadily declining, the number of people without access to sexual, reproductive and maternal health services is still high. Increasing the number of skilled birth attendants in the country is of great importance.

Action for Development (AfD) in partnership with the Geneva Haute École de Santé (HEdS) and with the approval of the Ministry of Public Health of Afghanistan, is currently expanding its midwifery training program to Laghman Province in eastern Afghanistan. This September, twenty midwives from various health facilities in the province are expected to commence training. Following a cascade-model approach, these midwives are expected to train 120 midwives. The training course covers topics including recognizing eclampsia, performing manual vacuum aspiration, vacuum extraction, reducing the risk of sepsis and family planning. Our objective is to prepare midwives from various health facilities at the community level with the necessary skills for the provision of quality maternal and neonatal healthcare.

Our Midwifery Training Program aligns with the UN Sustainable Development Goal no.3, which aims at reducing maternal and child mortality by 2030. Since the beginning of our program in 2014, over 400 midwives have been trained. This has been possible due to our generous donors and partners.

We would like to thank you for your continued support to the project!

 

Sincerely,

The team at AFD 

www.actfordev.org 

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Reducing maternal and neonatal mortality in Afghanistan

In today’s Afghanistan, women still face different challenges that prevent them from receiving adequate pre/post-natal health care, general insecurity being one of them. Most of the population also lives away from health facilities: in 2008, about 60% of the Afghan population lived at least two hours (by foot) away from a health care centre. Furthermore, because of cultural reasons, women cannot undergo consultations with male medical personnel. This is particularly problematic since female health providers are not available in every health facility. As a result, maternal and neonatal mortality are still widespread: the neonatal mortality rate is of 35 deaths for 1.000 live births, and the maternal mortality rate is 396/100.000.

To improve this alarming situation, in 2018 AfD collaborated with the Haute École de Santé of Geneva to train 21 midwives from the Takhar Province of Northern Afghanistan, whom in turn trained 128 additional midwives coming from different health facilities, in order for them to receive and develop the knowledge and skills necessary to improving the quality of care provided to pregnant women and young mothers. In total, 149 midwives benefited from the training last year. As a result of this training, not only mothers and newborns living in remote areas of the country were able to receive a better quality of care, but also the community was made aware of the importance of medical care for women and children.

In addition to the midwifery training, AfD was able to provide medical supplies for a particularly deprived health facility in Panjshir, located in the northeastern part of the country. As a result, this medical facility was able to provide standard basic healthcare to about 50.000 people. 

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Cascade training trainees, District hospital
Cascade training trainees, District hospital

259 midwives and nurses receive skills-gap training in Panjsher and Takhar Provinces to provide better services to mothers and newborns!

 

Giving birth in Afghanistan is still a dangerous ordeal that many women are risking their lives for, especially in rural regions. The country has one of the highest infant and maternal mortality rates in the world and 25% of children die before their 5th birthday (UNICEF). Most maternal deaths (80%) are preventable however, as the health-care solutions to prevent or manage complications are well known. In spite of this, women in Afghanistan have a 1 in 52 chance of dying from pregnancy related causes, compared to 1 in 4900 in developed and 1 in 180 in developing countries. This highlights the consequences of breakdowns in health systems in fragile states like Afghanistan as well as the importance of all births being attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby.

Since 2014, AfD has been working to reduce infant and maternal mortality by providing midwifery skills-gap training to midwives in rural Afghanistan. AfD’s program focusses on the major complications that account for nearly 75% of all maternal deaths (pre-eclampsia, eclampsia, complications from delivery as well as severe bleeding after birth). From 2019, five new training modules will also be available.

Current Modules

New modules, 2019 onwards

1. Care of the Newborn

 6. Family Planning

2. Pre-Eclampsia

 7. Nutrition

3. Eclampsia

 8. Manual Vacuum Aspiration

4. Management of 3rd Stage of Labour

 9. Vacuum Extraction

5. Postpartum Hemorrhage

10. Sepsis

These modules were developed in partnership with the Geneva Midwifery School (Haute École de Santé de Genève, HEdS).  They have been adapted for the country needs, aligned with Afghan government regulations and translated into local language. 

In 2017/18, AfD conducted training for 259 midwives in the Panjsher and Takhar provinces. These provinces were chosen due to an acceptable security level, the available infrastructure (availability of training centers, hospitals, accommodation etc) and a sufficient transport network. 

The training was conducted in two stages. In the first stage, 41 midwives were trained as master midwife trainers. These trainers then returned to their local health centers where, overseen by the Ministry of Public Health, they shared their new knowledge through cascade training of midwives and nurses in their local geographical area.  As a result, the professional skills and knowledge of 218 more healthcare workers in the two provinces was enhanced. 

In rural areas such as Panjsher and Takhar, where gynecologists are rarely available, the services midwives provide for women during their pregnancy, the birth and the postpartum period is vital. AfD’s collaboration with HEdS has enabled midwives in rural areas of Afghanistan to benefit from continued professional development, allowing them to increase their practical skills and knowledge in vital and life-saving areas, increasing their professional competence and confidence.

Now AfD is seeking funding to use the same methodology to train an additional 800 midwives in 4 other rural provinces; Kapisa, Laghman, Nangarhar and Parwan in 2019 and 2020.

We would like to thank you again for supporting our midwifery project. If you would like more information about the project and our latest project evaluation, please visit our website.

Please share our project details with friends and family. With further support, we will be able to save more lives.

 

Kind regards,

 

The team at AfD

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Organization Information

Action for Development (AfD)

Project Leader:
Zuhra Dadgar-Shafiq
Geneva, Geneva Switzerland
$4,141 raised of $50,000 goal
 
19 donations
$45,859 to go
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