1. Overview of Status of Women’s Health in Afghanistan Dr. S. M. Amin Fatimie Minister of Health Islamic Republic of Afghanistan Washington D.C. 14 July 2009

2. Progress has been made Access to health services is improving Quality of health services is improving Provision of health services is focused on children, women and the poor Mortality rates of children and women are declining Improved health system and well designed health policies and strategies

4. Expansion of Health Facilities 20022008

5. Expansion of Access – Population per Health Facility 2002 2008 1-25,000 25,000 – 50,000 > 50,000 No health facility Legend

6. Improved Access to Primary Health Care Source: MOPH/Johns Hopkins Afghanistan Household Survey, 2006

7. Reduced Child Mortality * Estimate for 2000 from 2002 State of the World’s Children, UNICEF ** Estimate for 2004/05 from 2006 Afghanistan Household Survey, Johns Hopkins and MOPH

8. The Tragedy of Badakhshan Despite the progress, there are still challenges One out of every 16 pregnant women in Badakhshan province dies as a result of pregnancy The average woman in Badakhshan becomes pregnant about 8 times; each time her chance of dying is 1 in 16.

9. What is causing all these deaths? Causes are medical, socio-cultural, geographical and logistic Medical causes: post-partum hemorrhage, obstructed labor, infection, eclampsia Socio-cultural causes: low levels of female literacy, persistent poverty, lack of a skilled birth attendant at delivery, early marriage, and the low status of women

10. What is causing all these deaths? Geographic causes: mountainous, rugged and remote terrain with no roads Logistic causes: no transportation (helicopters, ambulances, etc.), hospitals lack the staff and equipment to provide emergency obstetric care

13. So what can be done? Community-based interventions, to bring services to the community Train community midwives- we now have 27 midwifery education schools Increase deliveries with skilled birth attendants

14. So what can be done? Continue to strengthen the quality of health services Continue to strengthen access to C-sections and blood at health facilities More health facilities and equipment to enable women and children to access them

15. Women’s health in Afghanistan Although reducing maternal mortality is our highest priority, there are other aspects of women’s health that are also extremely important

17. So what can be done? Continue to educate women Work with community & religious leaders to encourage them to support & promote health seeking behaviors Develop and implement policies and laws to empower and protect women and children Gender-based violence law

18. Conclusions The health of Afghan women and children is in a better state today than in 2002 Our capacity to manage the health system is improving The financial and technical assistance from the United States has been crucial in saving lives and improving the health status of the women and children of Afghanistan We have achieved much with your help, but much remains to be done