New start for family planning in Afghanistan

Posted: 4 November 2002

After years of neglect, two new family health clinics are being established in Kabul, the Afghan capital, and traditional birth attendents (TBAs) are being trained outside the city in Parwan Province, 122 km from Kabul.

Devastation around the outskirts of Kabul but life goes on.© Imtiaz Mohammed/IPPFThe Afghan Family Guidance Association (AFGA) which had been dormant since 1992 has been reactivated with the support of IPPF. It now has five staff members, including a doctor, midwife and counsellor. Badly needed contraceptives are being supplied to the IPPF/AFGA clinic at the Rabia Bulkhy Women's Hospital.

The UN Population Fund (UNFPA) also supplied some of the equipment for the clinic which has seen over 200 clients in the first few weeks alone. IPPF/AFGA has also begun negotiations with two other leading hospitals in the city to establish new family health clinics at these hospitals. These are expected to open in the next two months.

Training birth attendants

A new clinic has also been opened at Guldara district, Kabul Province, about 45km from the capital. A local NGO, Afghan Educational and Rehabilitation Organisation (AERO) is running this clinic which will provide family planning, child and general health services to a population of around 38,000 people.

This area has suffered heavily from prolonged battle between the Taliban and Northern Alliance forces. Local people are beginning to return to the area and health services provided by the clinic are desperately needed. The clinic will have doctors, midwifes, counsellors and pharmacists. There will also be a small pathology laboratory.

A six-week TBA training course is also being conducted in Jabal Sharaj District, in Parwan Province 122km from Kabul. In all, around 80 TBAs will be trained and will provide safe motherhood services to a population of around 40,000. Traditional birth attendants being trained in Jabul Suraj.© Imtiaz Mohammed/IPPF
IPPF/AFGA has also signed a protocol with the Ministry of Women Affairs to provide contraceptives and reproductive health services to clinics run by the Ministry. The Ministry is planning to develop 16 clinics around the country and IPPF/AFGA is expecting the level of co-operation to grow.

Soaring death rates

The urgency of expanding such services is highlighted by reports of soaring maternal death rates in Afghanistan, with 50 women dying each day.

The vast majority of these pregnancy-related deaths are preventable, they say. A spokesman for the UN Population Fund described the situation as "extraordinary" and "shocking".

Estimates suggest that there are as many as 1,700 pregnancy-related deaths for every 100,000 live births. The main reason for the high death rate is a severe shortage of family planning and emergency obstetric services.

In some parts of the country, including the south and southeast, reported UNFPA, women cannot be treated by male doctors. The fundamentalist Taliban barred all women from education during its five years in power.

Peter Huff-Rousselle, the head of the UNFPA in Kabul, said: "In Afghanistan every day, 50 women die of complications related to pregnancy. Virtually all these deaths are preventable." He added: "In my own country Canada, with a somewhat larger population, it would be a national scandalif 50 women died of these causes in a year."

Afghanistan also has one of the highest infant mortality rates in the world - due to lack of access to medication and treatment.

Source: IPPF News, October/November 2002.