Hospital Maternity Ward Reopens

A baby boy weighing 2.85 kilograms was the first infant delivered at the newly rebuilt maternity ward of Kabul’s Khair Khana hospital, which reopened at the end of March. The mother, 40, was in good shape and proud to be the first woman to give birth in the new facility. It was her sixth pregnancy and second child, following four miscarriages.

The first baby born in Khair Khana hospital.

The small maternity and children’s hospital, serving a large, impoverished area of Kabul, was renovated and refurbished by UNFPA, the United Nations Population Fund. Work was carried out by the Italian NGO Intersos.

During the eight months that the maternity ward was closed for badly needed improvement, UNFPA supported the operations of a Danish Emergency Mobile Hospital near Khair Khana. The hospital treated 200-300 patients a day with trauma care, selective surgery, obstetrics and gynaecology; and trained over 100 local staff members. Between July and December, almost 1,500 babies were delivered at the facility.

Maternity ward prior to renovation.

Prior to the renovation, sanitation was very poor, rooms were overcrowded and improperly ventilated, building materials were worn out and difficult to clean, and equipment was inadequate or in disrepair; there was no working anaesthetic machine for women who needed surgery and no ultrasound equipment for proper antenatal follow-up and diagnosis. (See UNFPA press release) Now the hospital is fully equipped.

UNFPA is participating in Afghanistan's reconstruction as part of the integrated United Nations assistance mission. Priorities identified together with the Ministry of Public Health and the Ministry of Women's Affairs include strengthening maternal health services and girls’ education, with an initial focus on rebuilding health and education infrastructure.

Facade of new hospital.

Last year, at the request of the Ministry of Public Health and with funding from the Netherlands, UNFPA supported a crucial assessment of reproductive health care throughout the country, undertaken by the Japanese NGO Health and Development Services (HANDS). This was part of a comprehensive survey of health facilities, funded by the U.S. Agency for International Development, the European Commission, the Japanese International Cooperation Agency and UNFPA. Surveyors visited 1,038 health facilities, 2,952 community-based health providers and 1,149 pharmacies. The data will be used to determine needs and assistance priorities.

Population Census

After decades of devastating conflict, Afghanistan lacks the basic population and housing data necessary for development planning and the democratic process. The only attempt to conduct a national census, in 1976-79, was never completed. To address this shortcoming, UNFPA has been named as the United Nations’ lead agency to support preparations for a national Population and Housing Census.

Work is under way on a Household Listing Exercise, which constitutes the first phase of this effort. It is scheduled to be completed by March 2004.

The UNFPA office in Kabul has begun to strengthen and revitalize the Central Statistics Office, providing data processing equipment and organizing training for the staff in computer literacy, cartography and census fieldwork.

The pilot phase of the census started in January 2003 in Kunduz Province, after vehicles and other field equipment had been put in place, questionnaires designed for field testing, and field staff trained for their role. This work has been completed. Teams will soon be dispatched to three additional provinces. International donors—including Luxembourg, Denmark, Finland and Norway—have pledged to provide most of the $7.5 million estimated funding requirements for the first phase of the census effort.

Support to Health NGOs in Afghanistan

In addition to direct support to the Afghan Ministry of Health, UNFPA works closely with a number of nongovernmental organizations (NGOs) working to improve women’s health in Afghanistan. NGOs play a significant role in providing health care in Afghanistan, especially in underserved and remote areas. A number of national and international NGOs have years of experience and well-established networks. UNFPA is helping them increase access to quality reproductive health services and emergency obstetric care, providing needed supplies, and supporting training activities.

Last year the Fund supplied a variety of contraceptives to 20 NGOs active in reproductive health service delivery in 22 provinces. Using reproductive health supplies provided by UNFPA, some NGOs—including the Swedish Committee for Afghanistan, Hope Worldwide, the International Medical Corps, Merlin, Ibn Sina and the Afghan Red Crescent Society—offer basic as well as comprehensive emergency obstetric care. Several NGOs have also used UNFPA-provided supplies in the training of traditional birth attendants and of government health personnel in emergency obstetric care.

In 2002, the Fund started a new project with the Swedish Committee for Afghanistan, aimed at improving the delivery of mother and child health services (antenatal care, postnatal care, reproductive health and family planning, nutrition and immunization services) in clinics run by the committee. Project activities include:

• Providing basic emergency obstetric care to remote rural Afghan communities;

• Providing health education to women of childbearing age, through traditional birth attendants.

• Training traditional birth attendants and other female health professionals in reproductive health and family planning;

• Mobilizing community health committees to address maternal and child health concerns.

In recent months, UNFPA has also provided contraceptives and clean delivery supplies to:

• Ibn Sina, an NGO that provides primary health care services in 41 clinics around the country;

• Médecins du Monde, which supports maternal and child health clinics collaboration with the Afghan Ministry of Health;

• Afghanistan Red Crescent Society, which offers maternal and child health care as an integral part of its primary health clinics, and trains traditional birth attendants;

• MeRU Afghanistan, which has established two rural maternal and child health clinics and a health centre providing comprehensive emergency obstetric care in Balkh province;

• Terre des Hommes, which offers home-based midwifery services including prenatal and postnatal care, delivery, family planning and health education in Kabul;

• Afghan Educational and Rehabilitation Organization, which trains traditional birth attendants;

• Hope World Wide, which supports a number of maternal and child health clinics and one hospital

• International Medical Corps, which provides specialized care for mothers as well as children through a network of primary health care facilities.

Reproductive Health for Afghan Refugees

With its partners, UNFPA continues to support measures to reduce maternal mortality among Afghan refugees, tens of thousands of whom remain in camps and refugee settlements in Pakistan’s North-west Frontier, Baluchistan and Punjab Provinces. Supplies are provided for clean home delivery and for deliveries in camps’ basic health units. Support is also provided for staff training and emergency obstetric care referrals.

Support to Human Rights Commission

At the request of the newly established Afghanistan Human Rights Commission, UNFPA last year provided funding to create a Women’s Rights Unit within the Commission. In addition, it supported the Commission in organizing three workshops on a wide range of issues related to promoting women’s rights.

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