Afghanistan has one of the highest infant and maternal mortality rates in the world with many women dying needlessly due to a lack of basic healthcare during pregnancy. And, without a trained midwife, many mothers die due to a delay or inability to access medical attention. Two out of every three deliveries take place at home, without the presence of a skilled birth attendant. In many cases, women are still required to receive their husband or mother-in-law’s permission to leave the home and seek help.

In 2017, 10,000 birthing kits were sent by BKFA to World Vision in Afghanistan to support the health of mothers and newborns in vulnerable communities of the Western Afghan provinces of Herat and Ghor.

A pregnant woman receives a birthing kit at a maternal health clinic in Herat

Integration of Clean Birthing Kits

As part of the SEHAT (Sustainable and Improved Access to Maternal and Child Health Services) project, kits were given to women attending their 4th antenatal consultation and were also distributed by community health workers who undertook home visits to pregnant women in remote communities.

The provision of clean birthing kits acted as an incentive for women to attend clinics and receive support for maternal health and newborn care. At each consultation, women and their partners were educated about maternal and newborn health, the importance of nutrition, and were encouraged to have a skilled attendant at the birth.

The provision of free kits meant that women did not have to worry about the cost of medical supplies if they delivered their baby at a clinic. And since the SEHAT project began, the number of deliveries in clinics and maternal health centres has more than doubled.

Bibishah’s story

Bibishah is in her 9th month of pregnancy and is seen by a midwife named Marzia in a maternal health centre. She gave birth to her first child two years ago with the help of an unskilled traditional birth attendant, which left her suffering from back pain due to a vaginal infection.

“I have a lot of patients who suffer from vaginal infections who have given birth at home with the assistance of traditional birth attendants,” says Marzia.

Marzia notes that before the provision of clean birthing kits, she would often see newborns suffering from severe infections. She explains, “Many traditional birth attendants don’t use sterile blades or thread to cut the umbilical cord. Mothers [often] apply herbs and animal oil to the cord to dry it, leading to infection.”

The length of string in the clean birthing kit provides a simple and safe means to stem umbilical cord bleeding. “We used to use plastic umbilical clamps which was sometimes very dangerous,” Marzia says. “Usually after two hours the swelling of the umbilical cord is reduced and then the plastic clamp is loosened. If the mother doesn’t check the umbilical cord regularly, the baby may die due to bleeding.” Using the tie included in the kit is much safer than clamps, and the umbilical cord will usually dry safely within three days.

Marzia highlights the importance of antenatal care and gives Bibishah practical advice to ensure a clean and safe delivery. She helps Bibishah to map local clinics and birthing sites where her delivery can be attended by a midwife or community health worker.

When the consultation ends, Bibishah departs the clinic with a clean birthing kit in her hands and an understanding of the importance of pre-and post-natal care.

Confident and informed, she is empowered to protect her health and that of her newborn.

Thank you to World Vision Australia for a wonderful partnership!


Photography: Courtesy of World Vision Australia