Since 2014, AfD has been supporting efforts to improve midwifery training in Afghanistan. To this day, 211 Afghan midwives have had access to specialized training, and 31 midwives have been trained as midwife trainers.
The project began in the province of Herat in 2014, where AfD partnered with the city of Geneva, the Geneva Midwifery School (Haute École de Santé de Genève, département de sage-femmes) and the Ferdows Foundation to create a cascade model training program for midwives.
In 2014, 10 experienced midwives from community healthcare facilities in the province of Herat received trainer’s certificates after completing courses offered by AfD. Each of them was then sent back into their community with the mandate of sharing their new knowledge with 10 additional midwives. A total of 85 midwives received training in areas in which capacities are lacking, according to AfD’s and the Ministry of Public Health’s previous field research. These areas include pre-eclampsia, eclampsia, postpartum hemorrhage and appropriate management of the third stage of labor. Encouraged by the success of the program, AfD repeated it in 2015, this time in the provinces of Kabul, Parwan and Kapisa. One hundred and twenty-six midwives were trained, and 21 of them were coached in capacity building. This cascade model of training has the advantages of being very cost effective in areas where resources are limited and of reaching a larger number of people and has a greater potential of creating future community-based initiatives than traditional training models. In 2016, AfD expects to train 120 more midwives in the province of Bamiyan, including 20 midwife trainers.
The idea of midwifery training came in response to a dire need in communities. Under the Taliban regime, female healthcare specialists were banned from their jobs, and males were forbidden from caring for women. This created a huge gap in women’s health care with only 467 working midwives. When the regime was overthrown in 2001, the Government of Afghanistan hurried to answer the population’s needs, and by 2012 Afghan midwifery forces was up to 3500 (UNFPA 2014). However, the lack of time and resources did not allow for high-quality training for midwives. The course was limited to 18 months rather than the 4 years it lasts in developed countries.
AfD’s midwifery training efforts have contributed to the reduction of infant and maternal mortality and chronic health issues through better healthcare. Child mortality has fallen from one in four in 2001 to one in ten today. However, Afghanistan still has one of the world’s highest child and mother mortality rates. AfD continues its midwifery training efforts and improves upon then. We are currently working on adding nutrition modules to the midwifery training program.