“I examined the mother, only to find out that she had carried her dead fetus for weeks”, said Alia Ayar, a UNFPA midwife providing obstetric emergency care in times of humanitarian crises around Afghanistan. “She suffered severe pains and fever and couldn’t do the chores around the house, until the family (finally) decided to allow her to see a health service provider.”

Afghanistan has one of the highest maternal and neonatal mortality rates in the region: 1291 maternal deaths per 100,000 live births (AfDHS 2015).

“The beautiful and rugged mountains of Afghanistan provide a big challenge for access to health facilities, especially for pregnant women seeking antenatal and delivery services”, said Dr. Bannet Ndyanabangi, UNFPA representative in Afghanistan. “This, combined with other social, cultural and economic factors contribute to increased maternal deaths and ill-health among women of reproductive age.” 

Approximately 4.5 million Afghans have limited or no access to basic health care services, UNOCHA HNR 2017

The causes of maternal deaths are many; from limited access to quality  health services, to low knowledge about reproductive health, early/child marriage, multiple and consecutive pregnancies, shortages of female health care providers and many other cultural barriers hindering  women’s  access to health services. Furthermore, the recent wave of returnees and the large number of IDPs is posing a further challenge on already over stretched health care facilities and health care professionals in the country.

 “When there is a humanitarian situation UNFPA deploys Alia and many other midwives that UNFPA hires to provide emergency obstetric health care”, said Abdul Qader Raza UNFPA Humanitarian Response Officer.

Alia is member of a team, jointly funded by UNFPA and other organisations, with three other health service providers including a nurse, a doctor and a pharmacist who provide basic health care services during humanitarian emergencies.

Anisa is another midwife who has been providing basic reproductive health services for the past seven months to IDPs who escaped conflict from Kunduz located in Baharak district of Takhar.

While the majority of families displaced from Kunduz in Takhar have returned and the numbers decrease every day, Anisa says she still sees at least four pregnant mothers on a daily basis and refers complicated cases to the Baharak district clinic using the only vehicle that her mobile team has.

According to UNOCHA report, Humanitarian Needs Overview 2017, there are approximately 4.5 million Afghans living with limited or no access to basic healthcare services. In addition, estimates show that a further one million returnees and IDPs projected to have been on the move in Afghanistan in 2016 adding to the number of people in need of humanitarian assistance including health care.