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BMC Women's Health
Published in: BMC Women's Health 1/2014

Open Access 01-12-2014 | Research article

Development of the Community Midwifery Education initiative and its influence on women’s health and empowerment in Afghanistan: a case study

Authors: Elizabeth M Speakman, Ahmad Shafi, Egbert Sondorp, Nooria Atta, Natasha Howard

Published in: BMC Women's Health | Issue 1/2014

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Abstract

Background

Political transition in Afghanistan enabled reconstruction of the destroyed health system. Maternal health was prioritised due to political will and historically high mortality. However, severe shortages of skilled birth attendants - particularly in rural areas - hampered safe motherhood initiatives. The Community Midwifery Education (CME) programme began training rural midwives in 2002, scaling-up nationally in 2005.

Methods

This case study analyses CME development and implementation to help determine successes and challenges. Data were collected through documentary review and key informant interviews. Content analysis was informed by Walt and Gilson’s policy triangle framework.

Results

The CME programme has contributed to consistently positive indicators, including up to a 1273/100,000 reduction in maternal mortality ratios, up to a 28% increase in skilled deliveries, and a six-fold increase in qualified midwives since 2002. Begun as a small pilot, CME has gained support of international donors, the Afghan government, and civil society.

Conclusion

CME is considered by stakeholders to be a positive model for promoting women’s education, employment, and health. However, its future is threatened by insecurity, corruption, lack of regulation, and funding uncertainties. Strategic planning and resource mobilisation are required for it to achieve its potential of transforming maternal healthcare in Afghanistan.
Appendix
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Metadata
Title
Development of the Community Midwifery Education initiative and its influence on women’s health and empowerment in Afghanistan: a case study
Authors
Elizabeth M Speakman
Ahmad Shafi
Egbert Sondorp
Nooria Atta
Natasha Howard
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2014
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-14-111

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