 Birth & Midwifery in Afghanistan
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 Sabera Turkmani has completed her Bachelor’s Degree in Midwifery from Mashad Medical University, Iran, in 2002. Her experience in Iran involved working with Afghan refugees providing reproductive health services under a UNFPA-funded project. Upon returning to Afghanistan she worked with International Medical Corps (IMC) as a midwifery trainer in a tertiary referral teaching hospital. Since 2005 she was working with JHPIEGO, Health Services Support Project (HSSP), funded by USAID, where she was the midwifery technical advisor for JHPIEGO’s midwifery pre-service education programs in Afghanistan. She has experience in performance quality improvements in midwifery education and clinical site strengthening. She was also a leading member of the national midwifery education accreditation board and with the board has actively participated in the establishment of midwifery education policies and standards for the country. Sabera is currently working on a master’s degree in public health at the James P. Grant school of public health, BRAC University in Bangladesh.
Birth/Midwifery
About birth in Afghanistan
- Where giving birth is a forecast of death: maternal mortality in four districts of Afghanistan, 1999–2002, Linda A. Bartlett, et al., and the Afghan Maternal Mortality Study Team—Lancet 2005; 365: 864–70
- Trends in
Maternal Mortality: 1990 to 2008
The fifth MDG (WHO Millennium Development Goal) aims to improve maternal health with a target of reducing the MMR by 75% between 1990 and 2015. The adult lifetime risk of maternal death (the probability that a 15-year-old female will die eventually from a maternal cause) as measured in 2008 is highest in sub-Saharan Africa (at 1 in 31), followed by Oceania (1 in 110), and South Asia (1 in 120), while developed regions had the smallest lifetime risk (1 in 4300). Of the 172 countries and territories, Afghanistan had the highest estimated lifetime risk of 1 in 11.
- Afghanistan’s maternal and child mortality rates soar
- Afghanistan is among worst places on globe to be pregnant
- High Maternal Mortality Ratio in Herat Province, Afghanistan First Data-Driven Survey Details Health Crisis for Afghan Mothers —
full research report
- The Birth of Hope, March 2004 article on birth in Afghanistan
Education
 Midwifery in Afghanistan
[April 2007]
I arrived in Kabul two years ago, and started working at a rather new internationally-run hospital. Ten days after I got there, we opened the maternity ward, and I became the Midwife Supervisor, which included running the NICU, hiring and firing, inventory, protocols, etc. Quite a jump for a new CPM!
Afghanistan has the second highest maternal and infant mortality rates in the world: 170/10,000 maternal mortality rates and 165/1000 infant mortality rate, 257/1000 (that’s more than 25 percent!) under age five. Because of this tragedy, midwifery training has become standardized before nursing here.
Midwives can take one of two “tracks” here: Midwifery (hospital-based) and Community Midwifery (clinic and rural hospital based). The vast majority of women give birth at home, sometimes with a daya (traditional midwife). Women rarely go for prenatal care, or any kind of care, because of logistical issues (most of the country is very rural, mountainous, etc.), cultural issues (tradition of keeping women in the home, not wanting to ruin family honor by exposing them, etc.), as well as economic (not having enough money) and the lack of midwives (basically, no trained midwives work in the community—they are all clinic- or hospital-based).
Midwifery education in Afghanistan used to be for three years, now it is 18 months, in the interest of graduating more midwives. They learn normal pregnancy and birth, etc., but also are expected to do vacuum deliveries and some other procedures. Once they have finished their education program (which is a standardized curriculum, competency-based, from the Ministry of Health), they get a diploma, which is their midwifery registration. Some of the new graduates, with whom I did job interviews last year, were very poorly educated—they couldn’t give the definition of postpartum hemorrhage and what to do, when that is the #1 killer of mothers! I have heard that these students were from the worst midwifery school in the country, and that the others have much higher standards and better teacher-student ratios.
— Sharon Craig
Kabul, Afghanistan
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