(formerly IRIN News) Journalism from the heart of crises

Planning a child? Then avoid the winter months

Winter poses extra and avoidable health risks to many poor women who lack access to heating supplies and nutritious food in immediate postnatal situations, health experts say
Masoud Popalzai/IRIN

Some health specialists are suggesting that couples plan pregnancies so that the mother’s due date does not fall in the cold winter months. This, they say, will help save lives.

Wazhma, 23, had a baby in December and one of her main problems is how to keep warm.

“Often my baby and I shiver at night,” she said, adding that her family could not afford to heat even one room in their house in the southern suburbs of Kabul.

Winter poses extra and avoidable health risks to many poor women who have just given birth and who lack access to fuel for heating and nutritious food, health experts say.

Blocked roads in some areas due to snow or avalanches impede access (sometimes from November to April) for health workers, and many women are consequently forced to go without regular health and obstetric care, especially during the winter.

Cold-related diseases such as pneumonia and respiratory infections kill hundreds, if not thousands, of mothers and infants every year, according to aid agencies; and when fuel is available for heating, the fumes given off are frequently damaging to mother and child.

“If families avoid child delivery in the difficult season of the year [winter], some health problems which originate from cold weather will be prevented,” Abdullah Fahim, a spokesman for the Ministry of Public Health (MoPH) in Kabul, told IRIN.

Fahim’s suggestions were echoed by Marghalay Khara, director of health and social affairs at the Ministry of Women’s Affairs: “Child delivery in winter is associated with many problems which can be avoided by better family planning.”

Afghanistan comes just after Sierra Leone in terms of having the worst record on maternal and infant mortality and the reasons for this go beyond lack of access to essential healthcare.

The estimated maternal mortality rate (MMR) is 1,600 per 100,000 live births, and infant mortality is 129 per 1,000, according to the UN Children’s Fund (UNICEF).


A study by a group of Afghan and Japanese health experts released in September 2008 indicated that illiteracy among pregnant women played a significant part in maternal and infant deaths.

“A lack of education of the mothers, child marriage, lack of maternal autonomy, shortage of basic material needs and internal displacement showed independent and significant negative associations with child health and nutritional variables in this country,” concluded the group in their report.

The female illiteracy rate is over 70 percent, according to UNICEF.

Raising awareness in rural communities on pregnancy planning and its implications for maternal and infant health is a continuing challenge for the MoPH and NGOs.

The MoPH, in collaboration with the Ministry of Pilgrimage and Religious Affairs, has trained dozens of imams to help curb maternal mortality through raising awareness about the need for birth gaps and the dangers of child marriage.


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