Giving birth in Afghanistan is still a dangerous ordeal that many women risk their lives for, especially in rural regions. The country has one of the highest maternal mortality rates in the world. In 2015, for 1000 live births, there were 4.1 infant mortalities in Switzerland for 45 infant mortalities in Afghanistan. As over 83 percent of maternal deaths are preventable with timely interventions (WHO) it is vital to continue training midwives.
AfD has been delivering skills-gap midwifery training in Afghanistan since 2014 and has trained 490 midwives to date in seven provinces. The quality of our midwifery training content is highly regarded; it was developed in cooperation with the Haute Ecole de Santé in Geneva (HEdS) based on the training needs identified by AfD, the Midwives Association of Afghanistan and the Afghan Ministry of Public Health. While the cost of delivering midwifery training through AfD’s program is relatively low, the quality of the training is on a par with international standards. AfD is able to maintain low costs by using Afghan master trainers, local transportation services and sourcing local resources.
Most recently, AfD conducted trainings in the provinces of Pandjchir and Takhar, chosen for their rural population, acceptable security level, infrastructure (training centers, hospitals, accommodation) and sufficient transport network.
AfD uses a cascade model of training; in the first stage, 41 women followed the program to become midwife trainers themselves. Then these trainers returned to their local areas and shared their new knowledge with midwives across the provinces, under the supervision of the Ministry of Public Health. As a result, a total of 259 midwives received training in key capacity areas identified by AfD’s and the Ministry of Public Health’s previous field research. These midwives receive official certification and are now better prepared to save mothers’ and newborns’ lives in Pandjchir and Takhar provinces.
In rural areas, where approximately 75% of the population live but where gynecologists are rarely available, the services provided by midwives for women during their pregnancy, the birth and the postpartum period are vital. AfD’s partnership with HEdS enables midwives in rural areas to benefit from relevant training materials, adapted to their needs and cognisant of the lack of resources that they are confronted by in their daily work.
In addition to the midwifery training materials developed in recent years, AfD is continuing its partnership with HEdS in 2019 to develop new modules covering topics identified through our project evaluation. “The continued development of our midwife skills-gap training program is integral to providing Afghan midwives with access to quality training to improve their skills in essential, life-saving areas,” says Alison Farnham, AfD’s Public Health specialist.