The problem

Afghanistan’s health status is one of the most challenging in the world. In the past ten years Afghanistan has made impressive progress in providing health services to its people - the Afghanistan Mortality Survey, for example, released in late 2010, showed significant reductions in the rates of child and maternal mortality rates, testament to improvements in services. But significant challenges remain. Among them are a lack of skilled medical personnel and an overall lack of access to health care , high newborn mortality rate, and high prevalence of chronic and acute malnutrition.

What we do

Community Midwifery Education and Community Nursing education programs
Giving birth is still one of the most dangerous moments in the life of an Afghan mother. Maternal and child mortality rates have dropped significantly, but still one in 50 women dies due to pregnancy related causes, and the rate of children dying within their first 28 days is not decreasing quickly enough. This is why Save the Children focuses on training more midwives to save the lives of mothers and newborns. We ran midwifery schools in Jawzjan Northern Province of Afghanistan from 2004 to 2013. More than 137 midwives have been trained in Jawzjan. Save the Children runs schools in Uruzgan in 2012 and is now training the first 24 midwives – female nurses for a poor and remote province with nearly no midwives for tens of thousands of mothers. To ensure that female health workers are able to work successfully and safely in this difficult environment, applicants are always chosen by the local health shura and other community leaders. Health facilities have already guaranteed to hire the midwives after graduation.

Capacity Building and Curricula
Save the Children is actively involved in raising the capacity of a broad range of health workers including staff of health facilities (doctors, nurses, midwives) and volunteer health workers in communities. Trainings include sessions on pneumonia and diarrhea prevention, malnutrition detection and treatment, vaccinations, maternal and newborn care (ante- and post-natal care, birth preparedness, and family planning), depression, rational use of drugs, personal hygiene, and infant and young child feeding. We also develop training manuals on health issues for all levels and support the Ministry for Public Health to develop curricula and materials for use as part of the Basic Package of Health Services. They have contributed to nationwide capacity building in the fields of Interpersonal Communication and Counseling, Community Mobilization or the training of religious leaders on children’s and mothers’ health.

Supporting Sub Health Centers
Save the Children provides rural health centers with medical equipment and their staff with training. We also partner with local organizations to build and run rural health posts.

Establishing Mobile Health Teams
Save the Children have established mobile health teams in order to provide more health care for underserved communities. They consist of a doctor, a midwife, and a vaccinator travelling remote districts and taking care of those who rarely see skilled health workers.

Maternal and Newborn Care
Improving maternal and newborn care is a main goal of Save the Children’s health activities in Afghanistan. Midwifery education (see chapter on previous page) and the training of community health workers (see chapter capacity building) are part of our efforts, but we constantly seek to implement new ideas. The establishment and training of Family Health Action Groups is one of them. The purpose of this project is to provide life-saving, simple and low cost interventions and to ensure an increased coverage of services at home and in health facilities.

The groups consist of female volunteers from communities who receive basic training on ante and

post-natal care. One woman is responsible for supporting ten families. The groups are designed to

enhance the knowledge of family members about maternal and newborn care and build their confidence to deliver these services at home to mothers and babies in the post-natal period. Once trained, the members of the Family Health Action Groups visit pregnant mothers and mothers with newborns  in their own community and educate them on birth preparedness, maternal nutrition, ante- and post-natal care, and family planning.

Advocacy and Campaigns
Save the Children advocates on all levels for better healthcare for mothers and children. Thus we launched a global campaign namely EVERY ONE campaign, with the goal of reducing child mortality by two-thirds. We aim to increase the coverage of proven health and nutrition practices, help make government systems more capable, create nationwide awareness about newborn care and child survival, and implement high impact interventions with a focus on underserved areas. The Local to Global initiative within the EVERYONE campaign aims to link community-level child rights approaches to national and global advocacy work. At the community level the project builds the capacity of health shura members, empowering them to take part in the health system and enabling them to ask providers for accountability. At the national level we advocate for closing the gaps identified in the delivery of health services, and we work with the government and donors to change policies and secure funds for new interventions. therefore the Local to Global initiative supports Save the Children advocacy activities on acceleration of Health workers training particularly midwives, nurses and CHWs, advocacy around newborn health , advocacy to donors to support nutrition element and particularly C& MAM within BPHS .