UN helps reopen family guidance centres in Kabul

Standing amongst a gathering of women in a reproductive health clinic in the Afghan capital, Kabul, Patooni tried to convince her audience - many of them mothers of seven to 15 children - of the merits of family planning. "Please note that a smaller but sound and healthy family is better than a bigger family with too many ill and illiterate children," the 35-year-old health educator said, speaking to a group of some 50 women at the Malalai Maternity hospital reproductive health centre. "In Kabul we visit mothers who have given 15 consequent live births with no miscarriage. This does not mean they want so many children but they don’t know family planning methods," Patooni explained. In Afghanistan, husbands rarely use condoms, while only some women rely on the usage of intra uterine devices (IUDs) or contraceptive pills to prevent unwanted pregnancies. "Very few people know what a condom is and often husbands do not allow women to apply the Loop [local name for IUDs]. This is all due to a lack of awareness among men and women in Afghanistan," she said, adding that method was employed by only five out of 100 women visitors daily. At least seven major reproductive health care centres are reactivated in maternal hospitals of Kabul after funding was made available by the United Nations Population Fund (UNFPA) in August. Run by the local NGO, Afghan Family Guidance Association (AFGA), initially funded and supported by the International Planned Parenthood Federation (IPPF), the clinics were forced to close due to funding problems in June. According to Ahmad Zeya Yousufzai, executive director of AFGA, the agency received funding from IPPF until late June, with further funding for the project pending for the registration of the AFGA with the IPPF, the leading international organisation on reproductive health. "The UNFPA funding, which is US $50,000 for the next six months, is a vital bridging assistance this year until we are fully registered with IPPF in 2006 and get our budget from its core fund," Yousufzai explained. But according to AFGA, very little is happening on the issue of reproductive health care outside the capital, making the challenge and need for further funding even greater. Afghanistan has one of the highest maternal mortality rates in the world and according to a recent Afghanistan national human development report, one woman dies in the country every 20 minutes. Meanwhile, according to the United Nations Children's Fund (UNICEF) child mortality was very high in the war-ravaged country. Afghanistan’s first national human development report, released in early March, indicated that 20 percent of children died before the age of five. Yousufzai believes one of the reasons behind maternal and child mortality, as well as morbidity, is a lack of family planning and giving birth to too many children without a gap of two to three years between each live birth. "The minimum number of children in an Afghan family is seven and often we come across women with more than 10 live births,” he said. In a further effort to spread the message, Yousufzai said religious leaders and youth groups were being used to convey reproductive health messages to local communities. AFGA centres receive more than 700 women visitors each day. The centres offer guidance and services on family planning, HIV/AIDS awareness, youth and adolescence, reproductive and sexual health and gender-based violence advocacy.