Afghanistan Health Services Support Project Presented by Denise Byrd Former Jhpiego Country Director, Afghanistan, & HSSP Chief of Party 8 May 2013

2 Background & Context  80% of the 32.7 million Afghans live in rural areas  Cultural and geographical barriers limit access to health facilities  Health service delivery is contracted out to NGOs

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State of Health 4  Afghanistan had the second highest maternal mortality rate in the world  1 woman died every 27 minutes and 78% of deaths were preventable  Average family has 6 children  The risk of dying from pregnancy- related causes in Afghanistan was 1 in 7; while in the US it’s 1 in 4,300.  Afghan & US Governments were committed to reducing maternal deaths

5 Improving Maternal & Newborn Health in Afghanistan Improving quality Educating & training Generating demand Integrating gender

What We Achieved 6 Improved quality of care Trained 17,000+ health workers, a majority of which were women Implemented key community-based interventions to save lives Established & strengthened a national midwifery education system and a community health nursing education program for women

Midwifery Education 7 Newly graduated midwives in Badakhshan province take midwifery pledge

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9 From the Mouths of… “Previously there was no midwife in our village and women were suffering bleeding and their children were dying. Now thanks to God, we have a midwife and since have not seen a pregnancy death.” “In the beginning, people thought that I might be a dayee (traditional birth attendant) and would not be effective. Now, they know me as a women’s specialist and they respect me and say that I solve their women’s problems.”

10 From the Mouths of… “Before there was no midwife in our health center and we had to travel over one hour to the nearest town. I had all my babies at home before because of this. But now Midwife Hadia is at the health center and because of this more women are seeing a midwife. I will have my next baby with Hadia in this health center. She is very nice and makes me feel safe.” Woman in Takhar province who was delivered by Midwife Hadia

HSSP: Improving Quality of Life  HSSP interventions targeted and benefited women and their families while also strengthening the capacity of the MoPH  Interventions empowered women  Education  Economic opportunities  Mobility & Confidence  Improved health improves quality of life  Development that focuses on sustainability is essential to long-term security 11

12 Thank You!