Reducing Afghan maternal deaths
One woman in eleven dies from pregnancy-related causes in Afghanistan which can be relatively easy prevented. Working with village women themselves, their husbands and the health service provider we are introducing means which will continue to prevent as many deaths as possible each year.
Maternal mortality was the highest in the world. Most rural maternal deaths are due to delay in deciding to make the journey from a remote village to the health centre when a woman goes into labour and the time it takes to get there. Newborn babies die from hypothermia. Before we started one in five children died before the age of 5. Most under-five deaths in summer are from drinking infected water and in winter from pneumonia. 65% of children are stunted (UNICEF).
The project will raise women’s and men’s awareness of specific risks of pregnancy and childbirth and enable them to detect complications and take action at an early stage. Outreach antenatal care by midwives will also help detect problems and midwives will draw up birth plans with women and their husbands. Heads of village women’s groups can phone for emergency transport. Provision of clean water and fruit and nut trees and vegetable gardens will reduce malnutrition.
We aim to reduce maternal and newborn mortality in two districts of Balkh Province
Activities» We will provide health education to women and men, through village self-help groups, to reduce risks before and during birth.
» We will provide outreach by midwives to villages to provide antenatal and postnatal care and birth planning.
» We will provide emergency transport for women with complications of labour to health centres or hospital.
» To improve access we will repair sections of village roads destroyed by rains.
From reports of village women's groups at monthly meetings we record births and any deaths in villages against baseline data from village women for 2 years before project start.
We aim to reduce under-five mortality in the two districts.
Activities» We will work with villagers to provide sources of clean water to reduce dysentery and deaths from dehydration.
» We work with villagers to enable them to plant fruit and nut trees and vegetable gardens to reduce malnutrition.
» We will ensure the Community Health Workers in each of 60 villages are supplied and supported to provide basic health care there.
As above. We triangulate above reports with data from volunteer village Community Health Workers. We aim to ensure that lessons are learned from every death or near miss.
When women and men find that deaths are not simply the will of Allah, but with basic knowledge and skills and by basic, low-cost measures they can usually be prevented, they are empowered to make changes to improve their lot. This knowledge will remain. Women discover that they have rights, which they had hitherto not conceived of. The success of the project will be demonstrated by continued reduction in mortality.
The greatest risk is insurgency and associated lawlessness. Our greatest protection is the full support of villagers. We also receive daily bulletins on security. The team does not travel at night and when possible avoids travel at regular times. There is some risk that after project end the owners of vehicles who provide emergency transport may increase their charges or midwives may be unwilling to continue antenatal and postnatal care in villages without additional payment.
We will report to donors halfway through the funding period and on termination, showing how their donations have been spent. Reports will include photographic evidence.
Budget - Project Cost: £68,630Loading graph....
Amount Heading Description £8,688 Activities Mobile phone costs, travel costs, midwifery visits, medicines, clean birth kits. £26,007 Afghan project staff Afghan project staff, 5 full-time £12,287 Logistics Road repairs and transport for staff in the mountains, office running costs and communications £4,000 Clean water Provision of clean water in villages £9,065 Nutrition Mainly building crop storage to prevent rot £8,583 UK Management Project and financial management and bank costs
Current Funding / Pledges
Source Amount Brynberg and Pacey Foundations £23,276 Guaranteed Philip Henman Trust (over 3 years) £5,000 Guaranteed Bryan Lancaster Trust £300 Guaranteed Reekie Trust £700 Guaranteed Eleanor Rathbone Charitable Trust £2,000 Guaranteed Southall Trust £2,000 Guaranteed Karen Woo Foundation £3,412 Guaranteed Purley Overseas Trust £1,000 Guaranteed
The population of the 60 villages of Charkent and Marmul Districts is circa 34,000. These are very poor subsistence farmers and share croppers who have been forced up the mountainsides of the Hindu Kush onto poor and very eroded soil. Many can’t feed their families adequately and describe constant hunger. They are mostly Hazaras and Tajiks. In the civil war period before the Taliban village was fighting village, but they co-operated to keep the Taliban out.
We expect half of the women and children to benefit during the year, but the greatest life-saving benefit will be to the approximately 1000 women in those villages who can be expected to give birth in the year, their newborn babies and children under five. The people gain hope from our work together. Following our discussions with UNICEF, it prioritises Charkent District for immunisation (the worst in the province) and sanitation and hygiene.
Founded by doctors and allied professionals, HealthProm has built experience in development work over 25 years, including 10 years in Afghanistan. The project has an excellent Afghan project team who have won the total trust of he villagers and have good managerial and accounting support from London. Thanks to their work we have, with villagers reduced the number of maternal and child deaths by 65 in the last year from the average death rate in the two years before the project started.
Read more about the Charity running this project.
Dr Azada Parsa,
In-country Project Manager, has two years of obstetric experience and has shown great motivation to help reduce deaths.
Director of Operations, has gained the full trust and co-operation of village men in work on water, horticulture and road repair.
Finance Administrator, does the record keeping and accounting.
HealthProm's Director of Operations, takes overall project management responsibility in UK.