We work with mobile midwives who visit the most vulnerable families at home around Kabul to provide maternal and child health care as well as social support services. They also contribute to improve women’s access to public health services.
Our impact
15'696
births assisted by skilled birth attendants in 2022
10'545
new-borns and their mothers received post-natal care within 48 hours of childbirth by skilled professionals in 2022
2275
women attended at least 4 antenatal care consultations by skilled personnel during their pregnancy in 2022
Because of on-going conflicts, the return to power of the Taliban, the geographic isolation of some regions and poverty that is exacerbated by multiple factors, Afghan women have difficult access to quality health services, which leads to high maternal and neonatal mortality. To improve mother and child health, prevent and better address complications, Terre des hommes (Tdh) has supported displaced populations who live in the most deprived areas of Kabul since 1996.
We currently operate in more than twenty displaced people’s camps and poor communities in Kabul, often located far from health services and very rarely connected to running water. Young children often suffer from malnutrition and anaemia and mothers are exposed to early marriage and repeated pregnancies.
Giving birth under supervision
Our professional midwives reach the most vulnerable and displaced women and children through home visits. Women are assisted throughout the pregnancy, labour (in case the woman cannot access a health facility due to cultural reasons or lack of resources) and during the postpartum period.
Being present in key moments
The initial hours, days and weeks after delivery are the most dangerous moments for both the mother and her child. Records have shown that most deaths occur during delivery and immediately after childbirth mainly due to complications of pregnancy and childbirth. Trained midwives can identify risks early and can refer women to health centres if needed. In the follow-up visits, women are also informed of danger signs of the postpartum period and on proper care-seeking. Moreover, they are counselled on the importance of handwashing, new-born care such as breastfeeding, and the importance of vaccination. In addition, midwives treat ill children under the age of 5 and provide counselling to their mothers.
“Before, we didn't get vaccinated, we didn't go to the hospital to give birth. Once, a mother died during childbirth. Now, this doesn't happen anymore,” says Tashbibi*, a 22-year-old woman and mother of two children who was supported by Tdh.
Working with the families
Through the close relationship the midwives have with the families, they can advise them not only on family planning and child health, but also organise group sessions about violence against children and other issues arising for mothers and young women in their community. We train women to promote healthy practices with their neighbours and increase the awareness of families on the availability of services offered by Tdh midwives and health facilities. Health improvement is therefore combined with social work to give children a safe and healthy environment to grow up in.
Furthermore, children and family members at risk or that are victims of violence are supported with psychosocial activities and followed up individually by our social workers. They collaborate closely with the midwives to identify children and mothers at risk, address urgent protection needs, support the victims, provide psychosocial support and mediation or refer children to specialised care if needed.
“Midwives play a very important role in the country. They have the knowledge of the socio-cultural determinants and epidemiological context of maternal and newborn health and ethics that form the basis of appropriate care. The midwives participate in the promotion of health and well-being in the community and serve as a link between the community and the health system. They provide high quality, culturally sensitive health education and family planning services and treat women before, during and after the child is born,“ concludes the health project manager.
*Name changed for protection reasons