Afghanistan

Afghanistan: On the frontline in the battle against infant mortality

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The Maternity Ward at Malali Women's Hospital in Kabul is quiet ... until it is not. The relative sense of calm is suddenly shattered by calls for assistance, and a delivering patient is rushed in by her panicked mother. In just the recent past, the complications facing the would-be mother in labor could well have spelled tragedy. But thanks to new initiatives undertaken by the United Nations and the Afghan Health Ministry, the medical team on duty in the ward is better prepared to handle an emergency.

The delivery room at the hospital remains ill equipped by Western standards. But it is clean. As soon as the patient arrived, the attending doctor jumped from her lunch and quickly examined her, giving rapid orders in Dari. The only decipherable word is "breech." The midwives sprung into action, prepping the soon-to-be mother for birth. There's not an electrical device in sight and the furniture is well past its prime. Light shines in through the massive windows.

Against formidable odds, the delivery goes well, and a healthy, very fortunate (at least for the time being) baby boy enters the world. The story might have had a very different ending, if not for the training that the midwives and doctors had gone through.

The infant mortality rate in Afghanistan is among the highest in the world. According to CIA estimates for 2009, 151 out of 1,000 infants died during the first year of life this year. The rate has remained steady for much of this decade, but there is now hope that the mortality rate may be ready to gradually improve.

The UN is helping Afghan officials to conduct programs to train to medical staff on how to respond to difficult deliveries. Afghan and UN officials are also developing programs that seek to improve the health of fetuses in the womb so that babies are better able to withstand the rigors of birth.

The World Health Organization has provided training for 248 doctors and midwives in the hospital to improve skills in basic and comprehensive emergency care and newborn resuscitation. They have also supported a Neonatal Intensive Care Unit for infants with post-birth problems, such as low oxygen intake, jaundice and congenital abnormalities.

In April, the Afghan Health Ministry and the UN launched a new "family health action group" to improve the health and nutrition of pregnant women. Outreach program are being organized to encourage women to give birth in a hospital with a trained midwife, rather than at home - a popular method in the outlying provinces. Emphasis is placed on vaccines, (measles is also a leading cause of post-birth mortality), as well as well-baby visits.

In addition, the Ministry of Public Health, with the WHO's support, is conducting studies that analyze the hemoglobin of the delivering mother, as well as use a partograph, or heart monitor, in an effort to identify ways to reduce stress on babies during labor.

The efforts are slowly paying off. Zaroh, a new mother, brought her daughter Zaharah in to the clinic complaining that she is eating less. Such visits have the potential to prevent the child from growing sicker. Diarrhea and measles are common causes of infant death and both are easily treatable if caught early.

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