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Maternal Health 2019

Women helping women: how maternity care, for displaced people, is changing

Credit: Muslim Hands Afghanistan

Dr Abrahim Khairandesh

Regional Partnerships Manager, Muslim Hands

While maternal and infant mortality rates in Afghanistan may be dropping, the often-confusing figures still highlight that further work needs to be done to tackle the societal issues these women face.


Trust in the medical community itself has been eroded, and many fear vaccinations and health professionals due to a lack of information.

To understand the high maternal mortality rate in Afghanistan, it is important to first understand the living situation of many women.

In Kabul, there are only two maternity hospitals. Due to geographical and cultural obstacles, many women find it hard to travel to facilities, so often go without pre and post-natal care.

‘Taboo’ to seek medical help

With thousands of families displaced by conflict, traditional roles of local women acting as midwives are no longer being fulfilled. Trust in the medical community has been eroded, many fear vaccinations and health professionals due to a lack of information. This distrust prevails, and it can often make the concept of seeking medical help taboo.

International aid bodies have worked to tackle some issues, but the involvement of NGOs in Afghanistan is declining, and the issues are so wide-ranging that progress is slow.

We have a saying in Afghanistan that, with one hand a mother rocks the cradle, and with the other she rocks the world.

In 2011, one clinic, run by the charity Muslim Hands, came up with a unique solution. They began training local women as community health workers, reaching out to mothers and pregnant women in their own homes. The only requirements were that workers must be women who lived in the community and had a secondary school education.

Now, women who cannot attend the clinic still have access to basic medical care, advice and support. The health workers are also instrumental in identifying cases where women need more advanced medical interventions.

Training local women in healthcare

Dr Abrahim Khairandesh says: “We realised that we needed to provide an alternative way of caring for these women and believe our community health workers are the way forward. They bridge the gap between primary care services while also providing a low-cost means to identify high-risk cases.”

Despite initially being mistrusted, community workers are now sought out for advice and are the first port of call for a pregnant or new mother. “I have heard stories of dogs being set on our community health workers and doors slammed shut but, after a few visits, the door eventually opens. “These women are now welcomed and seen as guests of honour. That has only come with years of hard work and integration.”

With the notion of: ‘leave no one behind’ and the importance of maternal health in shaping the future of all societies, Dr Khairandesh calls upon everyone to extend their support. “We have a saying in Afghanistan that, with one hand a mother rocks the cradle, and with the other she rocks the world.”

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