Management Sciences for Health REACH program highlighted in Pak Tribune

HEADLINE: Afghan midwives aim to reduce maternal and child mortality

KABUL, AFGHANISTAN (OCTOBER 8, 2004) —  Afghanistan has one of the highest maternal mortality rates in the world, says Kaswera Vulere, a Midwifery Training Coordinator with World Vision.

The country's health care system was left shattered after more than two decades of war, with medical care for pregnant mothers and newborns almost non-existant in the countryside.

"The high rate of complications shows clearly that antenatal care is very low in the rural districts," continues Kaswera. "The midwives and doctors are not trained in midwifery techniques. Their previous referral system is not working, or non-existing."

In order to reduce maternal and child mortality in western Afghanistan, World Vision is currently training 50 midwives at the Institute of Health Sciences facility in the city of Herat. This in depth training will take two years for the Afghan students to complete, before they are posted to rural at-risk communities. This program is funded by US AID, through the Management Sciences for Health.

Finding qualified female applicants for the midwifery program was a challenge in Afghanistan. All applicants had to be female, since the strict rural culture would not allow for a woman in labour to be assisted by a man who is not a relative. Once it was determined that all the midwives would be women, this created another problem. Most of the female applicants from communities at risk grew up without a formal education. This was due to destruction of schools from the war, the conservative rural culture discouraging girls' education, and the outright ban on female education by the Taliban, which wasn't lifted until they were ousted three years ago.

After advertising through the media announcing the search for more applicants, WV health teams went out to the villages, additional interviews were held, qualified applicants were found, and the 50 selected women began their midwifery training in Herat.

'Healthy Families at Home', is the vision statement for World Vision Afghanistan, and midwife training fits well into the county's health strategy, aiming to improve rural healthcare for Afghan families. The program is part of the Rural Expansion of Afghanistan's Community based Health Care, (known as REACH.) After completion of the two-year course in March, 2006, the 50 midwives will eventually be based in communities across western Afghanistan, where maternal and child mortality currently ranks among the highest in the world.


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