Maternal Mortality in Afghanistan: Prioritizing women Dr. Sayed M. Amin Fatimie Ambassador Islamic Republic of Afghanistan

Basic Facts capital: Kabul Religion: Islam 99%, others 1% Language: National official languages are Pashto and Dari, up to 40 other languages are spoken, multilingualism is common GDP: 14 Billion

Afghanistan & Japan AfghanistanJapan Geography:LandlockedArchipelago Area:647,500sq.km377,873sq.km Topology:Arable land, mountainous, deserts Mountainous Population:28-32 million127.7 million Demographics (age):0-14: 44.7% 15-64: 52.9% Over 65: 2.4% 0-14: 13.1% 15-64: 64% Over 65: 22.9% Population Growth Rate: 2.375%-1.278%

Maternal Mortality Ratio - Historically

Afghan Women in Society Women are valued members of Afghan society, both now and historically. Afghanistan was a regional leader in women’s rights, having allowed voting rights and many other rights early. By the 1970s and 80s, women’s place in society increased to the point where, among many other achievements, women outnumbered men at Kabul University.

Maternal Mortality Ratios Under the oppressive Taliban regime, women lost many rights. In one such example, women were not allowed to be doctors so women were not given proper care. Due to this, women’s heath problems increased – and progress in areas such as the Maternal Mortality Ratio stopped.

Maternal Mortality Ratios In 1978, the mortality ratio in Afghanistan was 3,040 per 100,000 live births In 2002, the mortality ratio was 1600 per 100,000. Comparatively, Japan was 10 per 100,000 and the US was 13 per 100,000 in Regional nations also had lower ratios – Bangladesh, for example, had only 382 deaths per 100,000 live births (according to WHO estimates).

Steps Taken to Save Lives

Actions Taken In 2003, a hospital for midwifery education was erected with the support of USAID In 2003, Basic Health Care Packages were launched, prioritizing the reduction of the Maternal Mortality Ratio and Child Mortality Rate In 2007, the Maternity Waiting Home Project was launched, helping 1000 women per month with prenatal care, natal care, and postnatal care A series of educational pamphlets was created and distributed nationwide

Results Between 2002 & 2009: 38% reduction in Maternal Mortality Ratios 2010: According to preliminary reports by John Hopkins University and the MoPH and other sponsors to be released soon, MMR is now 290 per 100,000 live births – a tremendous decline. While a great improvement, still compared to countries like Japan, who had 6 deaths per 100,000 live births in 2008, we are still far off from where we aim to be.

Working towards even more lives saved

Future Goals Reaching the Millennium Development Goals (created in 2002): For Afghanistan, we aim for a reduction of the MMR by 75% by 2020 (50% by 2015 and an additional 25% by 2020) Establishing at least 1 healthcare center for every 25,000 people Employing 30,000 healthcare workers, including an increased number of midwives

Goals: How we will get there Through expanding such successful programs as the “Basic Package of Health Services,” made in association with USAID, the World Bank, EC, JICA, and other stake holders which focused on training local Afghans on sanitation and medical procedure, nationwide Expansion of the midwifery schools Implementation and Expansion of the Essential Package of Hospital Services (EPHS) Promotion of use of offered medical services and public health education

Manana – Tashakor – ありがとうございます – Thank you