On International Day of the Midwife, INTERSOS is urging the international community and the governing authorities not to turn their backs on women and children in Afghanistan. If funding to the health system is not urgently reinstated – and further expanded – many of the gains made over the past 20 years risk being reversed
INTERSOS midwives working on the frontline of the health response in Afghanistan fear there will be a devastating increase in the maternal mortality rate over the next three years if funding to the country is not urgently increased. In 2021, Afghanistan already had one of the highest maternal mortality rates anywhere in the world, with 638 deaths per 100,000 births. Now, with surgeons’ salaries going unpaid since the change in government and equipment and medicines being in short supply, the capacity of many hospitals to carry out life-saving operations on women with complicated deliveries has become severely compromised.
At the Provincial Hospital supported by INTERSOS in Zabul Province, where over 1,100 babies have been delivered since the start of the year, over a quarter of the women who have given birth there have experienced major complications and needed specialist care. If specialist treatment is not available to women when they need it, it is likely that many will die from these types of complications.
On International Day of the Midwife, INTERSOS is urging the international community and the governing authorities not to turn their backs on women and children in Afghanistan. If funding to the health system is not urgently reinstated – and further expanded – many of the gains made over the past 20 years risk being reversed. In 2002, Afghanistan had the highest maternal mortality rate of any country, anywhere in the world, estimated at 1,600 deaths per 100,000 births. Over the past 20 years, with support from the international community, the maternal death rate has dropped by 60% to 638 deaths per 100,000 births. However, if action is not taken now to prevent the situation from deteriorating further, it is predicted that the maternal mortality rate will rise by over 50% to 963 deaths per 100,000 births by 2025.
Rana Bahar*, an INTERSOS midwife working on the front lines of the health response in one of the most-remote parts of Kandahar Province, said: “Over the past few months I’ve seen that the situation has already begun to get worse in Afghanistan. When I first started working as a midwife in 2016, if any mother needed a caesarian section, surgeons were in the hospitals to do these operations. If a mother had a postpartum haemorrhage – which is the leading cause of death for women giving birth in Afghanistan – we had surgeons who could perform hysterectomies. But now, if I refer complicated cases from our rural clinic to the District Hospital, there are very few surgeons left there anymore. The funding has run out, so they haven’t been paid for months and they’ve left to look for work elsewhere. The lack of funding also means that hospitals don’t have enough equipment, and they don’t have enough medicines. So I am very worried that we will see the maternal mortality rate increase by even more than 50% if these issues are not addressed.”
Nasr Muflahi, Country Director for INTERSOS in Afghanistan, said: “Afghanistan’s health system is under an immense amount of pressure. Already, hospitals are overstretched, and we are hearing worrying reports that this is becoming increasingly evident in the maternity units. Even before August, it was difficult for women to access health care when they needed it – now it is becoming even harder for them to do so. Without increased funding to get these health facilities fully functional again, we will tragically see many women die from entirely preventable causes. Although NGOs are stepping in and scaling-up their work, they cannot fill the gap that has been left by the withdrawal of international funding. Ultimately, the continued freezing of aid will cause additional harm to women and girls – the very people that all those with an interest in the future of Afghanistan wish to protect. It is imperative that the international community and the governing authorities act now. It will not only save lives, but it will also make it possible for us to continue building on the gains that have been made over the past 20 years so that Afghanistan can reduce its maternal mortality rate even further.”
*Name changed to protect her identity