Housing for Midwives in Afghanistan Increases Access to Maternal Care
Midwives can decrease the risk of mother or infant dying during childbirth. For many expectant mothers in Afghanistan, especially those in rural provinces such as Maidan Wardak, a midwife is the only health care provider they may ever know, since traditional beliefs prevent women from being treated by male doctors.
For three years, the thousands of women in Maidan Wardak province’s mountainous communities essentially had no access to health care, because there were no midwives in the province’s nine different health facilities. Maternal and infant deaths were common. Efforts to recruit midwives from adjacent communities failed, as they could not travel for long distances alone, and the health facilities had no housing for female employees.
The health of mothers and infants began to change last year, with the support of Management Sciences for Health’s Technical Support to the Central and Provincial Ministry of Public Health project (Tech-Serve), funded by the U.S. Agency for International Development (USAID). Launched in 2006, Tech-Serve is working with Afghanistan’s Ministry of Public Health to build the capacity of the country’s health system and improve access to health services. At the provincial level, Tech-Serve supports health leaders to manage the development of accessible, equitable, and quality health services. In Maidan Wardak, for example, this meant finding solutions to the lack of maternal health care in the province.
The Maidan Wardak provincial health team, with Tech-Serve’s support, worked with the local health facilities to develop proposals to construct family houses for female health workers, so they could attract midwives from other communities. They sought funding from the local governments as well as community contributions to mobilize all the necessary resources. Local residents donated land for the houses and labored to help construct the homes. Each of these houses has three rooms, plus a kitchen and bathroom, and is enclosed in a secure place next to a health facility.
Today, four of the nine health facilities have female health workers providing maternal and child health services.
Hamida, a midwife at the Tagab District Hospital, is one of the province’s new female health workers.
“Walking daily for two hours from my house to the health facility was a problem for me and I was worried about my children,” said Hamida. “Thanks to the provincial health directorate for the construction of these houses, there are now three midwives working in this facility.”
Construction will start on housing for midwives for the other five health facilities later this year.