Training Midwives in Afghanistan

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

Afghanistan still has one of the highest maternal mortality rates in the world. Major contributing factors are a lack of access to primary health care and conservative traditions that make it hard for women to see a male doctor. Most rural areas have few trained midwives and women have no choice but to rely on birth attendants with little medical knowledge.

Training schemes for midwives play a key role in the reduction of maternal and infant mortality rates. Our training scheme has already trained 331midwives in the provinces of Herat, Kabul, Parwan, Kapisa, Bamyan and Panshjer. We have recently received funding from the Conservation Food and Health Foundation, which will allow us to launch the training in Takhar province, and to develop new training modules for the second phase of midwifery training.

Regular training updates based on the newest methods and medical research is vital to ensure quality care for mothers and infants. We will add five new modules to the training; these were based on an evaluation of our previous training and include: nutrition during pregnancy and early childhood, manual vacuum aspiration (a safe and effective treatment option for women undergoing early pregnancy loss), vacuum extraction (a common form of assisted natural delivery, used when labor is not progressing and/or when there are health concerns for the infant/mother), family planning, and maternal and neonatal sepsis (a leading cause of death for women and newborns that can be treated if caught early). Quality of care will be applied throughout the training process.

We would like to thank you again for supporting our midwifery project. Please share our project details with friends and family. With further support, we will be able to extend our care to more mothers and infants in Afghanistan, and save more lives.

Kind regards,

The team at AfD

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Afghanistan remains one of the most dangerous places to give birth. There are an estimated 396 maternal deaths for every 100,000 live births there. A major contributing factor is that two out of every three deliveries take place at home, without a skilled birth attendant. Mothers and infants at heightened risk are those in rural areas, where access to healthcare is extremely limited.

Over the past four years, our midwifery project has been significantly contributing to the professional training of certified midwives in rural areas of Afghanistan. So far, we have trained 330 midwives. The course provides two weeks of comprehensive training for midwives to enhance their 18-month basic training so that they can provide quality health care to mothers and infants. Selected midwives are intensively trained to become midwife trainers. Each trainer passes on their knowledge to five other community midwives; a cost-effective approach to knowledge-sharing.

We now have the results from the project evaluation. Interviews with trained midwives, Ministry of Public Health representatives (MoPH), master trainers, and patients revealed that, overall, the training was well-received, and resulted in improvements in the professional capacity of midwives. Suggestions included having a longer, more intense training period, and adding new training topics. These suggestions will be incorporated into our future training programs.

Examination of regional statistics pre- and post-training showed an increase in the number of pregnancy-related consultations, pre- and post-natal visits, deliveries in health facilities, and family planning consultations. Maternal and infant mortality rates were constant throughout this period. Taken together, these findings indicate that our midwifery program is effective at improving the capacity of midwives, and, with continuation, has the potential to contribute to a reduction in maternal and infant mortality rates in Afghanistan. For those who are interested, the evaluation report will soon be available on our website.

We would like to thank you for the support you have given to this project. With further support, we can continue to improve the care that mothers and infants receive in Afghanistan, and give them a chance to survive and thrive.

Kind regards,

The team at AfD

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When the mother of a newborn infant dies, the child has only one chance in four of surviving until its first birthday (UNICEF).

More than 50 percent of pregnant women in Afghanistan do not receive any antenatal care, and just 31 percent of deliveries are attended by a skilled professional (MoPH, Afghanistan).

The situation is particularly alarming for those living in poorer, rural areas, where as little as 3% of deliveries have been reported as having a skilled professional in attendance (Bartlett et al, 2017).

In rural Afghanistan, villages often remain cut off from the centre during the winter months, which hinders their access to health services. It is therefore critical to have a health provider in these villages, who is knowledgeable and capable of recognising and treating health problems.

This is why Action for Development (AfD) remains committed to training midwives in deprived areas of rural Afghanistan, and ultimately reducing the incidence of death and illness amongst mothers and infants.

In November 2017, AfD conducted the first round of its midwives capacity building programme in the province of Panjsher, a mountainous region in northeastern Afghanistan, which had only one maternal health doctor in 2009 (UNICEF). Residents live in villages that are largely inaccessible by roads, and extreme weather frequently obstructs the few available transportation paths. Some women have to walk for hours, even days, to reach a clinic, and it can be difficult to transport emergency cases.

Twenty midwives from different districts of the province were brought together to the centre of Panjsher where they could enhance their knowledge on specific pregnancy and birth-related issues, including Eclampsia, Pre-eclampsia, managing third-stage labour, and newborn care.

The twenty midwives, who will be trained to become trainers in the following month, will pass on their new knowledge to eighty further midwives and community midwives.

We would like to thank you once again for supporting our project. Your support saves lives.

Best wishes,

The team at AfD

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In May 2016, the first baby was delivered at Action for Development’s (AfD) Comprehensive Health Center (CHC). We would like to take a moment to honour Sediqa, the midwife who delivered the baby, and who has shown great strength throughout her career. Sediqa, 24 years old, comes from the province of Logar, just south of Kabul.

"I feel so happy when I see mothers and their children safe and healthy, it’s the best feeling ever, seeing the happiness in the mothers' eyes when they hold their newborn babies"

Sadly, Sediqa's fate remains unusual among Afghan women of modest origins, and achieving her dream required great amounts of resilience and tenacity. "I came from a humble family in which my father is the only breadwinner", she says. "Therefore it was a great challenge to join the Midwifery Institution after I completed high school. My family had completely rejected the idea. Studying in the Midwifery Institution would add to the burden of our financial situation, which was already precarious. Also, the institution was far from our residence and the commute was dangerous."

Despite her family's initial opposition, Sediqa convinced them to allow her to attend the program. “My passion for midwifery was stronger than my difficult circumstances: I insisted to pursue my goal and managed to re-enter the courses and finish my studies.”

Sediqa joined AfD's midwife training project in 2015 in order to stay updated with new health and treatment innovations, and guidelines related to maternal, pre-natal, and post-natal care. “The program was very informative and I learned many new practices and ideas that have enhanced and refined my knowledge. I’m really proud of my profession as a midwife, which I love. I’ll continue to spread my message and provide services to women in need.”

Training midwives, like Sediqa, is key to reducing maternal and infant mortality in Afghanistan. This is why AfD remains committed to ensuring that mothers and their infants receive the care they need.

We would like to thank you sincerely for supporting our project. Your donations will help to save lives; and support women in a step towards eradicating poverty and hardship in Afghanistan.

Best regards,

The team at AfD

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Organization Information

Action for Development (AfD)

Location: Geneva - Switzerland
Website:
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Twitter: @afd_swiss
Project Leader:
Zuhra Dadgar-Shafiq
Geneva, Geneva Switzerland
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