Guest blogger Rachel Walden of Women’s Health News is posting here this week, while Christine is on vacation.
In Afghanistan, there is a movement afoot to dramatically increase the number of trained midwives available to serve women throughout their pregnancies. This is with good reason – a 2000 World Health Organization report estimated the nation’s maternal mortality as second worst in the world, at 1,900 deaths per 100,000 live births (compared with 20 in developed countries).
Under the Taliban, new midwives were not allowed to be trained, and it is estimated that only 537 of these skilled caregivers remained in the entire country by 2001.
As a result, renewed efforts have been put into training Afghan midwives in order to alleviate the high maternal mortality rate. The newly formed Afghan Midwives Association held its first national congress in 2005, with more than 200 midwives in attendance.
If you have access to the journal Midwifery, there is an editorial and special report on these efforts in the September 2007 issue. The report describes how those working on maternal mortality and midwifery training were essentially starting with a blank slate due to the lack of infrastructure, and the impressive work that led to the creation of a standardized curriculum, new approaches to midwife training and practice, and the recruiting and retention of new trainees, all in a relatively short period of time.
The chosen approach was to separate trainees into two tracks, with one track focused primarily on community health and outreach. Amazingly, the report indicates that “By early 2007, in addition to the six Institute of Health Sciences campuses, there were a total of 17 community midwifery training programmes being implemented.”
A recent NPR story profiles a midwife training program location, and the website for the documentary Motherland Afghanistan (mentioned in this previous post) also provides a brief intro to the problems of reproductive and maternal health in the country.