The worst place to be a mother

Authorities are striving to improve health conditions for women in Afghanistan, where maternal mortality and female life expectancy indicators are the worst in the world, says a new report.



According to the State of the World’s Mothers 2011 report, published on 24 June by NGO Save the Children, about 50 women die in childbirth each day in Afghanistan. One in three is physically or sexually abused and the average life expectancy of women is 44.



It said that more than 85 percent of Afghan women are illiterate, while 70 percent of school-age girls do not attend school for various reasons - conservative parents, lack of security, or fear for their lives.



Taking all indicators into consideration, “Afghanistan is the worst country” to be a mother, concluded the report, which assessed 164 countries. Children in Afghanistan, along with those in sub-Saharan Africa, too have the highest risk of death in the world. One child in five, the report said, dies before reaching age five meaning ‘every mother in Afghanistan is likely to suffer the loss of a child”.



“Despite improvements and achievements, we are still very concerned about maternal mortality in Afghanistan," Health Ministry spokesman Kargar Norughli told IRIN. The ministry was therefore giving “high priority to tackling maternal mortality and morbidity".



One strategy that has been adopted is the training of birth attendants. “The country is rapidly heading in the right direction but [it] will take time to establish the optimum human resource base to satisfy the requirement for skilled birth attendants to ensure that each pregnancy and delivery receive appropriate, timely and equitable care,” said Tahir Ghaznavi of the UN Population Fund, UNFPA.



Some 750 professional midwives graduate each year after 24 months of training and the number was expected to grow to 800 in 2012. “If one takes into account the number of midwives graduating in 2011, 2012 and 2013; some 2,300 midwives are expected to graduate and join the existing midwives,” Ghaznavi told IRIN.



Clinics far away



Part of the problem, said the Health Ministry’s Norughli, was that 85 percent of the population live 3-4 hours away from healthcare facilities and 35 percent either live too far from a healthcare centre or do not have access to such a facility at all.



There is also a widespread lack of public awareness about maternal care among communities especially in rural areas, lack of medical facilities available in remote parts of the country, and poor roads or transportation facilities.



Afghanistan is a land-locked, mountainous country where in some places it can take a day to travel on foot, or by donkey or horse, from one district to the next.



Save the Children said only 14 percent of births were attended by professional birth attendants. Most women either deliver at home with no help (their husbands being reluctant to take them to a professional birth attendant), or die on the way before reaching a healthcare facility.



"The old tradition of giving birth before an elderly, uneducated and unskilled woman is still widely practised in some remote parts of Afghanistan," the report said.



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