AfD has been supporting efforts to reduce infant and maternal mortality by providing midwifery trainings in Afghanistan since 2014. To this day, 261 Afghan midwives have had access to specialized training, and 71 midwives have been trained as midwife trainers.
The idea of a midwifery training came in response to the communities’ dire needs. Under the Taliban, female healthcare specialists were banned from their jobs, and males were forbidden from caring for women. This created a huge gap in women’s healthcare since there were only around 467 working midwives for a total population of around 20 million (World Bank). When the regime was overthrown in 2001, the Government of Afghanistan hurried to answer the population’s needs, and by 2012 Afghan midwifery forces were up to 3,500 (UNFPA 2014). However, the lack of time and resources did not allow for high-quality training for midwives. As a consequence, the course was limited to 18 months rather than the 4 years it lasts in developed countries.
The project began in 2014 when AfD partnered with the city of Geneva, the Geneva Midwifery School (Haute École de Santé de Genève, Département de Sage-Femmes) and the Ferdows Foundation to create a cascade model training program for midwives.
Following this, 10 experienced midwives from community healthcare facilities in the Afghan province of Herat received trainer’s certificates after completing courses offered by AfD. They were then sent back into their respective communities with the mandate of sharing their new knowledge with 10 additional midwives. As a result, a total of 85 midwives received training in areas in which capacities were lacking, according to AfD’s and the Ministry of Public Health’s previous field research. These areas included pre-eclampsia, eclampsia, postpartum hemorrhage and appropriate management of the third stage of labour.
Encouraged by the success of the program in Herat, AfD decided to continue its midwifery training project in other provinces. To this day, additional trainings have been held in the provinces of Kabul, Parwan, Kapisa, Bamyan and Panshjer. 331 midwives have been trained so far with 71 of them having received training to become midwife trainers themselves. This cascade model of training has the advantage of being very cost effective in areas where resources are limited and where reaching those in need is difficult. Furthermore , it has a greater potential of creating future community-based initiatives than traditional training models.
AfD’s midwifery training efforts have contributed to the reduction of infant and maternal mortality and chronic health issues through better healthcare. Overall, infant mortality rate has declined in Afghanistan from 88 per 1,000 births in 2002, to 53 per 1,000 births in 2016. However, Afghanistan still has one of the world’s highest child and maternal mortality rates. As a response, AfD continues its efforts to provide midwifery trainings and to improve the training modules. In addition, we are currently also working on adding nutrition modules to the midwifery training program.