Promoting Improved Family Planning at the Community Level in Afghanistan
Afghanistan's maternal and infant mortality statistics are universally recognized as being among the world's worst. One of the many reasons for this is the lack of awareness among the community about the importance of family planning to maternal and child health. Management Sciences for Health (MSH) is working, through the US Agency for International Development (USAID) –funded, Technical Support to the Central and Provincial Ministry of Public Health (Tech-Serve) project with the Afghan Ministry of Public Health to involve local communities in promoting culturally appropriate family planning practices at village level.
Throughout 2010, the Tech-Serve project supported the Ministry of Public Health's Community Based Health Care Department and expanded its integrated community-based family planning program. Implemented in 13 USAID-supported provinces in 2008 and 2009, the program has grown to include 11 additional provinces under USAID's Quick Impact Program. These provinces – in the country's south and east – are among the most insecure in the country.
The program trains community health supervisors to provide supportive supervision on post partum family planning to staff at community health posts across the country. These health posts, staffed by volunteer community health workers, one male and one female, operate out of community-donated space at villages throughout Afghanistan.
258 community health supervisors (248 men and 10 women) have now received in-service training to provide support to these community health workers in the implementation of effective birth spacing activities.
A total of 10, week-long training courses were conducted for participants from Logar, Laghman, Farah, Nimroz, Kunar, Nuristan, Nangarhar, Wardak, Uruzgan, Zabul and Helmand provinces in February/March and June/July this year. In addition to training in post partum family planning, participants received instruction in community based health care, supervisory skills, and techniques for effectively monitoring the program. These community health supervisors are now providing technical support to community health workers to mobilize and motivate their communities in support of family planning; address popular misconceptions; and promote family planning messages consistent with the Holy Quran.
The community health workers are providing counseling about birth spacing, administering the first doses of injectable contraceptives, and using community mapping as an effective tool for recognition of women within their communities who would benefit from family planning services. The improved quality of community based services being facilitated by the Ministry of Public Health is contributing to better perceptions by the Afghan people of their government's positive role in improving their health and a sustainable delivery of services at the community level.
The Tech-Serve Project is one of the main partners supporting the Ministry of Public Health in Afghanistan. Tech-Serve works at the central and provincial level to build the ministry's capacity to perform its primary function of guiding the health system by establishing national objectives that address national health priorities while ensuring equity and fostering sustainability. Tech-Serve project is an Associate Award under the Leadership, Management and Sustainability (LMS) Program funded by the U.S. Agency for International Development, and was launched in July 2006 by MSH.