Government set to tackle maternal mortality

The Afghan government announced on Wednesday that it would take steps to reduce maternal and child mortality in the country. "Currently, maternal and child mortality comprises 90 percent of our health problems," Dr Abdullah Shirzai, the policy director of the health ministry, told IRIN. "We have created a basic package of health services which prioritises the reduction of maternal and child mortality and decreasing of infectious diseases within three years," Shirzai said, noting that 16 women in every 1,000 pregnancies died, and one child in four died before the age of five. "The rate is the worst ever recorded in human history," he said. According to the ministry, lack of money, infrastructure and human resources were the main reasons for these critical human indicators being on the rise. "There are 1,000 health clinics in the country, but only one-third of them are operational," Shirzai said. "We need over 1,000 clinics to provide one health centre for every 25,000 people," he said, noting, however, that clinics were only part of the solution. "In Afghanistan, because of geography, if you are three miles away from a clinic, you have no access to the clinic because there is a mountain in front of you," Shirzai said. The ministry wants to employ at least 20,000 to 30,000 health workers, mostly women nurses and midwives, within one year across the country, many of whom would serve as outreach workers, taking health care to remote areas. Despite these huge health challenges, Shirzai is optimistic. "As we vaccinated 10 million people early this year, it should have had a major impact on many mothers and children, and in addition this year there have been new clinics and health services established in some parts of the country," he said, adding that the ministry aimed to reduce maternal mortality by one-third by 2006. Habiba Sarabi, the minister of women’s affairs, told IRIN that, apart from shortcoming in the health services, other factors were contributing to the shocking maternal mortality rates, and these, too, needed to be addressed. Chief among them was a lack of public awareness in traditional male-dominated Afghan communities. "The root cause behind maternal mortality is more than lack of health services: cultural backwardness and patriachal societies prevent women from accessing health centres, she said. Sarabi emphasised that many men in rural areas still refused to allow female relatives near a doctor, despite the presence of nearby clinics. "There are many such societies which do not like sending women to the doctor, as they regard doing so a shame," she said, declaring that in addition to health education, vast public awareness and literacy programmes could be useful in reducing maternal mortality. The United Nations Children’s Fund (UNICEF) as one of the leading agencies in mother-and-child care shares the concerns of the Afghan health ministry. "With the cooperation of the ministry of health, UNICEF has undertaken an initiative to create emergency obstetric care facilities in all provinces within the next one or two years," Chulho Hyun, a spokesperson for UNICEF, told IRIN, noting that this would be one of the best ways of tackling the very high maternal mortality rates.