Mobile Midwives in Kabul

We work with mobile midwives who visit families at home around Kabul to reduce mother and child mortality as well as to improve their health.

Because of ongoing conflicts and the geographic isolation of some regions, Afghan women have difficult access to health services, which explains why pregnancy and childbirth were among the main factors in mortality rate for mothers in the early 2000’s. Large population displacements only exacerbated the problem. To reduce the number of deaths, one of the most effective approaches is to establish professional continuity in the care of women and new-borns from the beginning of pregnancy to the first months of a baby’s life. Terre des hommes’ health project offers this since 1996.

 

We currently operate in more than twenty displaced people’s camps in Kabul. Everything is missing in these homes, often located far from health services and very rarely connected to running water. Young children generally suffer from malnutrition and anaemia. Mothers are exposed to early marriage and repeated pregnancies.

Midwives trained by Tdh visit the homes of mothers and their infants in the most vulnerable areas. During the visits, they identify pregnant women, monitor them throughout their pregnancy and accompany them during and after childbirth. The midwives also use these meetings to discuss the childbirth with the husband and family and to persuade them to go to a health centre for delivery. They also provide advice to parents to vaccinate themselves and their children and offer kits that allow for giving birth in a more hygienic environment. “Before, we didn't get vaccinated, we didn't go to the hospital to give birth. Once, a mother died during childbirth. Now, this doesn't happen anymore,” says Tashbibi, a 22-year-old woman and mother of two children who was supported by Tdh.

 

Being present in key moments

 

The initial hours, days and weeks after delivery are the most dangerous moments for both the mother and her child. Records have shown that most deaths occur during delivery and immediately after childbirth mainly due to complications of pregnancy. Trained midwives can identify risks early and can refer women to health centres if needed.

Through the close relationship the midwives have with the families through their house visits, they can advise them on family planning, child health and organise group sessions about violence against children and other issues for mothers and young women in their community. Health improvement is therefore combined with social work to give children a safe and healthy environment to grow up in.

"The house to house concept is extremely important in Afghanistan. The midwives know the socio-cultural and epidemiological context of maternal and newborn health and ethics that form the basis of appropriate care."

Doctor Noor Khanum, manager of the Kabul health project

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