Childbirth and maternal health improve in Afghanistan
Women in Afghanistan still face gender violence and have limited legal protection. But small gains in maternal health are critical for rebuilding Afghan society.
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"In the years before Karzai's government, whenever we used to go to these hospitals ... the patients would cry in the wards and no one would help," she recalls. "Now after what I saw in the clinic, I don't believe people are going to continue dying anymore," says Miriam, who recently visited the hospital.Skip to next paragraph
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One of the biggest challenges facing Afghanistan is getting medical care to people living in rural areas – about three-quarters of the population.
In many places residents simply do not have access to medical facilities, let alone roads. According to a recent Asia Foundation survey, only 57 percent of Afghans say they have good or very good access to clinics or hospitals.
As a result, tremendous effort has gone into training midwives who can help women through the birthing process absent a full medical facility.
Since 2002, the number of schools for midwives in Afghanistan jumped from six to 31, according to a report by Save the Children. Afghanistan now has more than 3,000 midwives (up from just 500 in 2003) with an additional 300 to 400 trained each year.
The report indicates that the efforts were successful early on with the number of births in rural areas attended by skilled medical professionals jumping from 6 percent to 19 percent between 2003 and 2006.
Even when hospitals are available, women tend to prefer to give birth in their own homes, without trained attendants. Thus, say health officials, a big part in combating maternal mortality is simply raising awareness so that women will choose to give birth at a clinic if possible.
"All the achievements we've made in Badakhshan Province are thanks to efforts to raise awareness among the people here," says Abdul Momen Jalali, the head of health services for Badakhshan, which has been hit particularly hard by maternal mortality. Even so, he adds, "We still have a lot of problems with remote areas where we don't have roads to access these areas." Notably, Badakhshan was the location of a major attack on foreign charity doctors in 2010.
No matter how much the country's health-care system improves, doctors say there is only so much that can be done in the midst of Afghanistan's ongoing war. Violence often inhibits doctors' travels or stops patients from reaching the nearest hospitals.
"The midwives and doctors cannot go to very risky areas. Even though the doctors do not know any borders, they're still killed, kidnapped, and threatened. I think the mortality [rate] that is happening right now still looks very high. It's coming from those areas where there is not any doctor or security," says Jalil Hassan, a professor of medicine at Kabul University.
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