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Afghan Women, Midwives, and High Infant Mortality

 

"I believe that if the life of only one person is changed or saved, something wonderful and monumental has been achieved and all efforts justified. Please be assured that we are very proud to have had a small association with the projects."

(Donor to a SAFE TBA Training Project)

 

TBA/CHW Instructor’s Comments - Dec. 2009

“An extraordinary change has been brought to the illiterate women whom started from zero and had no knowledge about health and hygiene issues at all. Now they have confidence and know about both children and motherly health issues. The ability of the trained trainees in order to help pregnant women during their pregnancy and after the delivery can be considered as a vital asset to these remote villagers.

As far as our training program has followed, the two objectives of the TBA program are related directly to the child and mother, and also public health awareness issues. According to my observation, there are a lot of changes being made within the community and households so far.”

 

v      Violent crime against women in Afghanistan hit record levels and became increasingly brutal in 2013. The latest figures for 2013, for March through September, showed a 25% increase in cases of violence against women.

 

~Why SAFE’s funding of TBA/CHW Training has been so vitally important~

 

v      Afghanistan has the second highest maternal mortality rate in the world; one woman dies every 27 minutes due to pregnancy-related conditions – around 25,000 deaths per annum.

 

v      The country has the highest mortality rate in the world for infants and children under 5yrs old.

 

·          Midwives: It has been stated in Afghanistan, by an Afghan doctor no less, that trained midwives in Kabul prefer to be unemployed and without a job rather than go to a rural area: a fact confirmed by the Act. Minister of Health H.E. Soraya Dalil on 3rd November 2010!

Most trained midwives are urban based. The same can be so often said for female teachers! Unfortunately there is a serious lack of support for a doctor, teacher or midwife’s family in terms of proper staff quarters in rural areas.

Nearly nine out of ten Afghan women give birth without medical help. Almost all Afghan women particularly rural women, give birth at home, mostly with the assistance of a Traditional Birth Attendant, but only about 8% get help from a trained medical attendant. Due to traditional and cultural restrictions male doctors or health attendants cannot help women give birth. More than 25% of children die before the age of five: in some areas it can be as high as 29%!

 

Mr. Shikh Sadiq: Community Representative’s Comments - Dec. 2009

“On behalf of our community, I would like to thank and appreciate a lot from SAFE and CAWC for supporting and conducting such productive training for the women.

We never had such an opportunity in our villages to see a project that the women are involved. We all know that the women can help each other and bring a positive and fundamental change to a family. Thank God! Now our families have the opportunity to access to a (DAYA) health worker to have a safe delivery and bring health improvement to our society.”

·          The maternal mortality rate that is 60 times higher than that of developed countries! Maternal mortality rates in rural areas are more than 10 times higher than those in Kabul. In rural areas particularly, giving birth can be a forecast of death!

 

·         The high maternal mortality of Afghan women can have many causes, including limited availability and accessibility of health services, poor health, including anaemia from chronic malnutrition and infectious diseases. Many of the latter are preventable.

 

·          Lack of resources and trained medical personnel, along with low levels of awareness and cultural factors, are the main reasons for alarming figures.

 

·          Trained midwives are rarely in attendance. If there are complications, it might take hours, even days to reach the nearest clinic.

 

·          Malnutrition is widespread in Afghanistan, particularly in rural areas. Many districts do not have a clinic: those that do so are still often found to be basic.

 

·          Life expectancy – 44 years, one of lowest in the world, some 20 years short of global average; "women in Afghanistan die at a younger age than men".

 

·          Safe motherhood benefits women. It also benefits their families, the community, and society. It is an essential component of development.

 

There's an Afghan saying: 'When the mother dies, the child is sure to die'.