By Habib Waqar
A recent survey reveals that the maternal and child mortality rate in Afghanistan has once again surged compared to previous years and the hopes that the problem would be addressed has gone forever.
Ministry of Public Health (MoPH) had announced last year to alleviate maternal and child mortality rate through a five-year plan of midwifery nursing. The maternal and child mortality rate was 237 women from 100,000 before but the figure is now 1,200 women from 100,000 Afghan women. Afghanistan is the second country in the world which has the highest maternal and child mortality rate after South Sudan.
The survey of MoPH shows that lack of medical facilities, midwiferies, lack of security and transport, and road damages were the root causes of hike in the figure. Meanwhile the public blame MoPH for deficiency of not addressing midwifery problems over the past 17 years.
Nation's Problem
An Afghan woman holds her newborn twins at the Razai Foundation Maternity Hospital in Herat province November 30, 2011. (Photo: Mohammad Shoib / Reuters)
Though a number of 25 girls were graduated from midwifery schools in Laghman province last year, yet residents' problem have not been solved. Residents claim that most of the midwives do not go to the remote areas and wish to be in provincial capital or Jalalabad, provincial capital of Nangarhar. Dad Mohamad Sardari, a resident of Ali Sheng district, said that most of the time women die during delivery. He said, "We have many problems in this regard and the government has never heard our voice. My brother brother's wife was pregnant and she died before we could reach Mehtarlam, provincial capital of Laghman.
He urged the government to solve their problems." Tokhai, another resident of the province, said that besides lack of doctors and midwives, road damages were also another problem they face. Paktika residents are also not far from the problem. Abdullah Totakhail, along with his three orphan children, said that they (Paktika residents) too have suffered different types of deficiencies and problems and women have died during delivery. He added, "We have screamed and rose up our voices too many times but our voices have never been heard. I am a resident of Orghon district, and my wife got sick a while back before delivery, before I could take her to a medical facility, she died. ….. This is not only my problem but all the residents'. "
Provincial Health Director Dr. Waligul accepts the problem but urges the families to encourage their daughters to seek education in the field and fill the shortage of midwives in the province. "We have faced many problems in mother and child health section, if they (people) don't send their daughters to midwifery studies; they should not expect the government would send the midwives from Kabul." He adds.
Some MPs (members of parliaments) also say that most of the areas in the country don't have health clinics as Sakhi Moshwanai the MP from Kunar province says that there are even provinces that have only one hospital and the women have to suffer traveling for hours to get to the hospital.
12000 Midwives
The World Health Organisation (WHO) says that some 4,000 midwives are working in hospitals and clinics across Afghanistan who solve people's problems. WHO is trying to accelerate its efforts in this regard and raise the figure to 12,000 midwives in the next five years, which would solve 80 percent of pregnant women's problems. WHO asserts that the maternal and child mortality rate has decreased now; that is, in the past 15 years one woman would have died during delivery in each half an hour while one women dies during delivery in each two hours now.
MoPH Efforts
Public Health Minister Dr. Firozuddin Firoz admits that they still need to work to bring down the maternal and child mortality rate. He accepts that a mother dies in each two hours during delivery. "The role of midwives is very important; we are trying to end the problem but a lots of works need to be done. Much work has been done now compared to the past," He notes.
Meanwhile Zulaikha Anwari, head of pregnancy department at MoPH, says that maternal mortality rate was 1600 from 100,000 in 2011 but lowered to 237 now. Anwari adds that the ministry of health has to encourage the girls to midwifery studies and would continue its efforts as the ministry has more midwifery studies centres than past and has many graduated midwives every year.
Pointing to re-raising of the mortality rate, she told the Killid, "The insecurities, road damages and shortage of midwives in rural areas are the problems which have raised the figure." She added that most of the families are guilty as the men don't pay attention to their wives during pregnancy phase, they are not fed well, and they carry heavy loads and don't take them to health centres in a timely manner." Anwari accepts that the ministry doesn't have female doctors and midwives in remote areas that have different causes, " There are many areas that dont have midwives , there are also remote areas that the midwives are not going to due to insecurity; we are trying to train local girls and give them jobs in their own areas."
The life of mother and child is another serious issue as many of the mothers die during delivery but still Afghans hope that maternal and child mortality rate would be lowered once the numbers of midwives are increased in future.
Originally published on Jun. 18, 2017