HealthProm

I am Dr. Hussain Ali Jahid and I manage and implement HealthProm’s project of decreasing maternal and newborn deaths in the remote and mountainous but peaceful district of Charkent, Balkh province, Afghanistan.

Whilst 78 percent of the population live in villages in Afghanistan, most of the government and NGO activities are concentrated in the cities. They are not sustainable, are top down (do no consult with villagers) and are just a demonstration.

They spend a lot of money training health workers in the cities, but when the health workers are sent out to the villages where there are no facilities, no buildings or equipment for health centers, not enough medicine, no electricity and no running water, the health workers are not able to deliver health services.

This hasn’t helped the negative perception of health workers. That is why Afghanistan has recorded the highest rate of maternal mortality in the world.  The rate of maternal mortality is 1,575 per 100,000 live births and newborn deaths are 220 per 1000 live births. This was recorded in Badakhshan in the north province of Afghanistan in 2010.

HealthProm’s project is fully participatory and bottom up and all of the activities are aimed at being sustainable and to empower the marginalized village men and women to help them to assess their health problems and devise steps to solve them locally.

The main aim of the project is to achieve Millennium Development Goal 5A, that is, the reduction of the maternal mortality rate by three quarters by 2015. We aim to show that this can be done in Afghanistan and how.

To make it sustainable that the villagers will be able to continue in the future, the heads of motherhood groups are shown how to make clean birth kits from materials found locally.

The project facilitators  are two couples who are trained in Participatory Methods locally and travel around on motorbikes to the villages.

The facilitators have set up 46 motherhood groups and 20 men support groups (all the village women and men are members of the groups) in 20 villages in Charkent. The heads of the groups participate in a monthly meeting with the project administrator and health centre staff.

During the meetings the heads discuss their health problems with staff to find ways to solve them locally and receive health massages, bearing them to their group members in the villages.

This has helped decrease the negative perception of health workers among the villagers and the villagers to have ownership for the health centre and also the security threat for the health workers is decreased.

Training health workers

To help the health workers to improve their skills and to provide health services for the villagers, HealthProm provides monthly training for them. The trainings are not in a room setting and focus not only on health issues but on their jobs and on behavioral issues (to help the health workers to behave properly with the villagers and to draw the villagers trust). Because most of the health workers are from cities and do not know how to behave with the villagers.

The topic of the trainings are also being selected after joint discussion with health workers, and HealthProm is playing a facilitating role in helping the health worker to recognize their need for training.

Providing CBKs (clean birth kits)

As infection and heat loss are known as major killers of  newborns in Charkent, HealthProm provides every pregnant women with a clean birth kit and baby blanket.  To make it sustainable that the villagers will be able to continue in the future, the heads of motherhood groups are shown how to make clean birth kits from materials found locally. The clean birth kits contain:

1- Squares of cloths and plastic sheets 2- A bar of soap 3- A razor blade to cut the umbilical cord 4- Gauze pad 5- An adhesive bandage 6- String to tie the cord

They also make baby blankets out of full-sized blankets.

Emergency Transportation

pregnant Afghan woman helped into car

It is a great challenge for the poor village women in labour to travel on donkeys or horses for 2 to 6 hours to get to the health centre for childbirth, especially in winter when the rough roads are covered with snow or in spring when it is destroyed by floods.

To support the women, HealthProm has provided a vehicle for emergency transportation for women in labour, transferring the women from villages to the health centre and, when it is needed, from the health centre to hospital in Mazar city.

To make it sustainable, HealthProm is working with the villagers to make a low-cost means of transportation that the villagers will be able to use when the project ends.

Written by: Dr. Hussain Ali Jahid, In-country Project Manager – Afghanistan

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