Supporting safe birth amid deteriorating situation in Afghanistan

Commitment to supporting childbirth amid Afghanistan’s deteriorating security situation
A midwife at a family health house provides care to a baby. Image taken in 2020. © UNFPA Afghanistan

DAIKUNDI, Afghanistan 

The delivery of reproductive health services, including safe birth, was seriously affected by the worsening situation in Afghanistan. Najaba, 36, experienced firsthand how the dangers of pregnancy collided with rising insecurity.

A mother of four from Zaradnay Village, Najaba visited the district hospital just before her due date on August 17. An ultrasound revealed that the fetus was in a transverse position, meaning it was lying horizontally rather than head-down. This is a dangerous complication.

The doctor told her she needed a Caesarean section, but Najaba was fearful of the operation. She left the hospital to give more thought to her situation. She even considered trying to deliver at home. “When the district hospital discharged me, I decided to do the delivery at home with support of my mother,” Najaba said.

But in the following days, growing insecurity caused many health facilities to close – including the district hospital. 

Najaba realized that if the delivery proved complicated, she would be unable to seek emergency assistance.

A desperate search for care

She called her mother in desperation. Her mother called many of the elder women in their community to seek advice. Finally, Najaba recalled, “My relative called me and informed me about a small clinic.”

It was the nearby Ghuchan Family Health House, a UNFPA-supported facility where a community midwife was still providing services, including safe birth, to pregnant women in Afghanistan. 

Not long after, Najaba went into labor. With her mother and husband, she rushed to the family health house. There, the midwife took her medical history, conducted a physical examination, and listened to her concerns. When Najaba expressed anxiety about the delivery, the midwife comforted her. She said they would try to deliver the baby without any surgical procedure. 

Then, four hours later, a healthy baby was born naturally

Najaba and the baby were both healthy and left the clinic soon after delivery. 

Keeping doors open

Najaba was relieved to safely welcome her fifth baby, and her family was overjoyed. She returned to the midwife for postnatal care and neonatal services for the baby. 

A women provides a health service to another woman.
A midwife at a family health house provides care to a woman. Image taken in 2020.  © UNFPA Afghanistan

She and her family say they plan to recommend the family health house to all pregnant women they meet. 

The family health house, located in eastern Daikundi Province, provides life-saving reproductive, maternal, newborn, and child health services. It is one of 172 family health houses in geographically remote villages where people have little access to health services. 

With support from UNFPA and local communities, these facilities have been able to continue operating or to reopen after a short closure, even amid the ongoing security situation. Services include prenatal care, safe delivery, and postnatal care, and family planning. Families can access nutrition services and integrated management of childhood illnesses services to children under five.

UNFPA originally published a version of this article.

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