Submitted by the USAID Maternal and Child Health Integrated Project (MCHIP)

Every 27 minutes, a woman in Afghanistan dies from complications due to pregnancy or birth. Across the country, midwives are the frontline health care providers working day and night to save these women. Educated with USAID support, Sadiqa Husseini, 24, is among the more than 2,000 new midwives who are helping to significantly reduce Afghanistan’s maternal mortality rate, which is among the highest in the world. Sadiqa was featured in a recent BBC audio slideshow on a day in the life of an Afghan midwife. The piece is a moving portrayal that demonstrates how USAID contributes to empowering women, rebuilding essential networks of skilled health care providers, improving health care services for women and families, reducing deaths of mothers and newborns, and strengthening communities.

Sadiqa had wanted to become a midwife ever since her sister nearly bled to death giving birth to her first child. At the time, Sadiqa and other family members relied on traditional means and home remedies to try to stop the bleeding. Ultimately, Sadiqa’s sister had to be taken to a hospital some 20 kilometers away. She and her newborn daughter survived, but Sadiqa’s sister never fully recovered and had no more children. The experience had a profound impact on Sadiqa.

“When I saw this happen in my own family, I wanted to become a midwife,” Sadiqa said. “I didn’t want other women to suffer like my sister and her family.”

Najiba Fazzay, a 35-year-old Community Health Worker (far right), gives a talk on maternal health care to expectant mothers in the village of Aquachanoy near Jawjzan, Afghanistan. USAID-funded programs have helped train 8,500 community health workers in Afghanistan. CREDIT: Jhpiego

USAID’s Health Services Support Project, in partnership with the Afghan Ministry of Health, allowed Sadiqa to realize her ambition. Through the project, accredited midwifery schools have been established in nearly every province of Afghanistan. These schools, assisted by USAID with partner organization Jhpiego, provide essential training for midwives like Sadiqa, helping increase the number of trained midwives to more than 2,000 (from about 450) since the fall of the Taliban.

Local health committees are involved in identifying and selecting candidates, a unique aspect of the program that builds support for midwives who return to their communities to work. Villages and communities have directly benefited from the increase in midwives: The number of Afghan health centers that are staffed with more than one midwife has increased from 10 percent (2002) to 61 percent (2009) since USAID began focusing on maternal and child health in Afghanistan in 2003.

The success of USAID-funded projects in Afghanistan has also led to the training of 8,500 community health workers and the formation of a professional midwife’s association, which includes 1,600 members. The impact of this expanded force of maternal health specialists is reflected in the increasing number of Afghan women who give birth with skilled care, a key intervention to reducing maternal and newborn deaths. According to the most recently available data, deliveries assisted by a skilled birth attendant in Afghanistan increased from 8 percent in 2003 to 19 percent in 2006.