In Afghanistan, more women are able to give birth safely

In the east region of Afghanistan, Première Urgence Internationale is improving access to maternal and neonatal care for women living in remote villages of Kunar Province. Thanks to this program, the number of institutional deliveries is increasing, in the five health facilities supported.

Afghanistan is a country with one of the lowest female life expectancy, despite one of the highest fertility rates in the world. Maternal mortality is one of the main causes of death among women in Afghanistan. Among other interventions, Première Urgence Internationale is actively improving access to maternal and neonatal care for women living in remote villages of the Kunar Province. The NGO tries to overcome barriers in access to institutional deliveries to allow for a sustainable change in health seeking behaviour, by:

• Mobilizing the community on the question of access to institutional deliveries in remote villages;
• Enabling the provision of qualitative and culturally acceptable 24/7 basic emergency obstetric and new born care services, through simple rehabilitation, staff training and construction of midwife accommodations;
• Facilitating institutional delivery through the allocation of financial support to pregnant women for transport cost; including the development of a financial pilot approach. This pilot project aims to create sustainable community fund so that; at community level; they can collect and distribute cash for pregnant women that can’t afford the transportation costs.

Thanks to Women Hope International, through the support of five health facilities, Première Urgence Internationale is directly supporting around 2,600 pregnant women and indirectly impacting 39,000 women and children under five, in the health facilities’ catchment area.

Improving access to maternal and neonatal care for women in Afghanistan

Sabrina, one of Première Urgence Internationale’s midwives, is from Kunar. She has been working with the NGO for two years now. First, Sabrina worked as midwife in a mobile health team. And since October 2018, she’s been working in one of the supported basic health care centres, in Kunar province. “I enjoy my work, as I meet new women every day and help them out in different aspects. For me, this is very important, as women in Kunar still face important challenges”, she explained. Focusing on institutional deliveries, she highlighted: “at the centre level, there are no ambulances for patients, so emergency referrals to a higher health facility can be complicated. Also, due to the existing financial barriers, drugs are expensive so often families can’t afford to purchase them.”

How do you feel working in a health facility as a midwife?

I’m satisfied and proud of my work. Every day, I receive 20 patients, most of them women. The reasons for the visits are different, from regular ante-natal and post-natal consultations, to breast feeding consultations, vaccinations, family planning, etc. I’m very happy to being able to provide health services to women that need them. In addition, thanks to Première Urgence Internationale’s project, I’m able to stay nearby the health facility, as an accommodation has been built. I have my own kitchen, bedroom and living room, so I don’t have to worry anymore about how getting home safely. And I’m available for emergencies 24/7.

What are the main obstacles to institutional deliveries, according to your experience?

One of the major issues is the lack of transportation. To visit a health facility in Kunar is expensive as they are far away, and no public transport is available. Another important issue is the lack of knowledge and misunderstanding regarding the services available. In a culture sensitive about female reproductive issues, many are not aware that in health facilities there are women available; there may not be enough privacy as there are medical doctors and guards that are all men.

Provide support to health centers

For this reason, Première Urgence Internationale supports this health facility with the provision of staff and rehabilitation of infrastructure. Delivery rooms have been upgraded, so that the services available are improved and privacy for patients is ensured. Furthermore, Première Urgence Internationale supports family health action groups. Through an advocacy and communication training (that I also received as a midwife), we are taught on how to improve the knowledge of communities in this regard. Trained community members actively refer women to our facilities, and are more capable of recognizing specific medical conditions. They inform the community on services available, the importance of delivering in a safe health facility. As well as giving more general advice on healthcare for mothers and children alike.

These activities have been funded thanks to the support of Women Hope International (WHI)