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Image: Educating midwives and nurses

Educating midwives and nurses

Educating female healthcare professionals to work in rural and remote areas takes time, but it is also a long-term investment with a huge impact. It is the most effective way to save lives of women, children and men.

Since 2002, NAC has educated 13% of the total midwifery work force in Afghanistan. In 2014, NAC also graduated the first batch of community health nurses. Today, NAC runs eight schools for midwives and nurses, in Kapisa, Khost, Laghman, Nangarhar and Wardak. 

In Afghanistan’s most remote areas, just under half of women go through pregnancy and birth without seeing a skilled healthcare professional. Distance, transport problems and poverty are the most cited reasons for not seeking skilled help, as well as cultural barriers.

In Afghanistan, most families do not allow for women to be seen by male doctors and nurses. Even if a woman lives next door to a health clinic in rural Afghanistan, she may not have access to healthcare
if there is no female health worker in that clinic. The Afghan health system only covers 23% of the need for maternal and new-born healthcare and one fifth of the need for female nurses. In short, Afghanistan needs many more female health workers, and most of them must go to work in rural and remote areas. 

Specialised education for rural conditions

The Afghan Ministry of Public Health has formed curricula for two types of midwifery and nurse education: one for urban hospitals and another for rural conditions, where the midwives and nurses have to be able to work in rough conditions with minimal equipment. All but one of NAC's schools educate community midwives and nurses, who will go back to their districts after graduation, to help where the need is greatest. 

NAC has supported education for hospital midwives at the Nangarhar Institute of Health Sciences (IHS) in Jalalabad since 2002. After finishing the two-year long program, these midwives will work for various health facilities in the province, including both district and provincial hospitals.

NAC also runs schools for community midwives and nurses in Kapisa, Khost, Laghman, Nangarhar and Wardak. Over a period of 18 months, the midwifery students learn to care for women during pregnancy and in and after birth. Not only do they study the physiology of pregnancy and birth, nutrition, hygiene and easily preventable diseases, but they also learn to approach culturally sensitive issues such as family planning, which can help reduce maternal mortality. An extra-curriculum program includes women’s rights, conflict resolution and sports.

The community health nurse students come from remote districts and undergo a 24 month long course before returning to the districts to provide basic healthcare.

Changing attitudes

Families from the conservative areas of Afghanistan are normally reluctant to send their girls to any education outside the home village, where they have to stay in a compound away from their family. When NAC started supporting the hospital midwifery education in Jalalabad in 2002, it was difficult to recruit students, particularly from remote areas. In 2012 IHS had nearly doubled the number of applicants from ten years ago. Many families were eager to send their daughters to school, which is a sign of increased acceptance.

In Afghanistan, few young and unmarried women are permitted by their families to work outside of the home. But as the communities see the benefits of having a skilled female health worker, being a midwife gains acceptance. The Afghan Midwives Association plays a central role in changing these attitudes. Established in 2005, it is the first Afghan labour movement for women. NAC works to strengthen AMA’s organisation and leadership capacity. 

Norwegian Afghanistan Committee
Addresse:  Nawai Watt, Street # 03 •  Postal addresse:
work # 148 Shahr-i-Naw, KabulAfghanistan

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