Celebrate Solutions: Midwives and Misoprostol in Afghanistan

By: Mariko Rasmussen, Program Assistant at Women Deliver

Badakhshan Province along the Northern border of Afghanistan is an impoverished, isolated, and remote mountainous region. There are few passable roads, and areas of unrest, making it dangerous to get health care, and difficult to get to help to villages. The region is experiencing some of the highest maternal and infant mortality rates in the world. But Afghans are trying to change that. The solution? Midwives. NPR reported August 29 on the impact of an initiative to recruit and train midwives in rural Afghanistan.

JHPIEGO’s midwife training program, funded by USAID, is making a difference. They’ve set up clinics and training programs for midwives in half of Afghanistan’s provinces. NPR visited some of the clinics to hear how they’ve improved care.

Midwife Farangis Sultani tells the story of a woman who had complications delivering twins, developing hemorrhage. Hemorrhage is one of five causes in developing countries responsible for nearly three-quarters of all maternal deaths. One of three women dies of hemorrhage in childbirth in Afghanistan. But the midwife was able to stop the bleeding by giving the mother injections. What if a woman can’t reach a clinic in time to give birth? The technical director of the midwife project explains that there is a cheap, effective intervention to this problem: Misoprostol. Health workers can carry a pill that stops bleeding and saves lives.

The training program had challenges to overcome – the men did not want their women working or traveling alone from their village. The women must spend a year at a school to complete the midwife training program. So, to engage male elders in villages, JHPIEGO created village councils to choose which women could attend the program. Making them active in the process seems to have helped alleviate cultural concerns, allowing women to return to their villages as proud midwives, empowering them to help their communities. 

Listen to the audio of the complete story here: http://www.npr.org/blogs/thetwo-way/2010/09/28/130180983/afghan-midwives-save-lives by clicking on “listen to the story.”