Saving the Lives of Newborns in Rural Afghanistan

Miriam, in Bamyan Province, Afghanistan, has three children—two other infants died within days of birth. She has just given birth to her sixth child. This time, however, it was different from the previous pregnancies. She and her female relatives had learned from the local female community health worker about the importance of keeping the baby warm. The old custom of bathing the baby right after birth to make the newborn clean was dangerous because the baby easily became cold and then sick. Instead, they should dry the baby with a towel and then place the baby on the mother next to her skin. Washing the baby could wait until later.

The community health worker said, "Until I received training about care of newborn babies, I just followed our old customs. I did not realize how important it is to keep the baby warm after it is born. Placing the newborn on the mother next to her skin is so simple, and the mothers like it, too."

With nearly nine out of ten births in Afghanistan still occurring in the mothers' home, Management Sciences for Health is implementing the US Agency for International Development's (USAID)  Basic Support for Institutionalizing Child Survival project (BASICS) in Afghanistan, with non-governmental organizations to train community health workers in Essential Maternal and Newborn Care. Community health workers can teach pregnant mothers and their families the simple, but important things that can be done to preserve the lives of newborns.

The key steps taught to the community health workers regarding the newborns are: the importance of ensuring the baby is breathing immediately after it is born; having good care of the umbilical cord by cutting it with a clean instrument at the proper distance from the baby's abdomen; keeping the baby warm by placing the baby on the mother; and, starting exclusive breastfeeding for the baby immediately after birth.

The Afghanistan Ministry of Public Health and USAID, through its projects, are seeking to help save the lives of babies born in homes in rural areas by ensuring that community health workers know the key newborn care lessons to share with pregnant mothers and their families. The families can now be more confident and better prepared. Through such efforts going on in many small villages and communities, they seek to reduce the unnecessary deaths that occur with many newborns throughout the country.

BASICS/Afghanistan is a USAID-funded project, implemented by MSH, which provides technical assistance in child survival to the Ministry of Public Health of Afghanistan to address newborn health, community case management of childhood illnesses, nutrition, pediatric hospital care improvement, behavior change communications, and systems strengthening. Beginning its country program in 2007, BASICS specifically works to improve child health in the country by expansion of the community-based Integrated Child Survival Package to 28 districts, introducing improved expanded program on immunization micro-planning at the community level to increase immunization coverage, developing key behavioral change communication messages for improved newborn and child health based on research findings, developing child survival policies and strategies; improving the delivery of newborn and child health care in communities, health centers and hospitals.