In Afghanistan, where every 30 minutes a woman dies giving birth, the empowerment of women begins with improving their health and that of their children. REACH recognized and responded to the important links between gender and public health.
The USAID-funded REACH Program specifically aims to improve the health of women of reproductive age and children under age five through the increased use of basic health services in rural areas. REACH advisors played an instrumental role in helping the Afghan Ministry of Public Health (MOPH) develop the Basic Package of Health Services (BPHS), which emphasizes maternal, newborn and child health.
REACH grants totalling $68 million to 25 Afghan and international NGOs are now providing access to the BPHS to 7.3 million people in 14 Afghan provinces. Among these are an estimated 1.5 million women of reproductive age.
Through the training of midwives and community health workers, literacy initiatives, gender training for NGO staff, and support for organizations of women health professionals, REACH is also empowering Afghan women to play an important role in the rebuilding of their country:
- The $6.7 million in USAID-funded REACH grants earmarked to train community and hospital midwives is modernizing and expanding midwifery education in both urban and rural areas. Over 800 women are currently enrolled in community and hospital midwifery programs.
- Trained staff and an upgraded, competency-based curriculum have revitalized midwifery programs on four regional campuses of the Institute of Health Sciences, where 337 professional midwives have graduated so far, the first trained in Afghanistan in the past seven years.
- REACH trained nearly 6,300 Community Health Workers (CHW), over half of them women, who are operating health posts in their local communities.
- Non- and semi-literate female Community Health Workers have been trained in the use of Community Maps, which enable them to record the BPHS service status of each household.
- To empower women to popularize BPHS activities at the community level, REACH has provided leadership training to over 400 female shura members. Involving women in these community health committees not only enables them to generate support for health initiatives and healthy behaviours in their local area but also helps engage the entire community in making decisions on health planning and health management.
- REACH prioritizes female health providers in refresher training courses. To date, women comprise over 50% of the 1,700 doctors, midwives and nurses who have attended refresher training in family planning, infectious disease, integrated management of childhood illness, or newborn care.
- Over 8,500 Afghan women are enrolled in Learning for Life, an accelerated, health-focused literacy program. Learning for Life, which is increasing female literacy and providing health education, is also expected to qualify many women for further training as community health workers and community midwives.
- The REACH Gender Unit regularly provides technical assistance to the recently formed Association for the Empowerment of Afghan Women Health Professionals, whose membership includes women health professionals employed by the Afghan Ministry of Public Health, NGOs, and international organizations.
- The REACH Gender Unit actively supports the Gender and Rights Unit established by the MOPH in August 2005.
- The REACH Gender Unit has held gender awareness workshops for the members of Provincial Public Health Coordination Committees in 13 REACH provinces, emphasizing the right women have to health care; participation in family planning decisions; and nutritious food, especially during pregnancy and adolescence.
- Afghan women are active in virtually every aspect of the REACH Program, from a female dispatcher in transportation and a female guard in security to women doctors, master trainers, and administrators.