“Themidwifehelpedme.OtherwiseIcouldhavelostmylife”Women´sperception,utilizationandexperienceofaprofessional
midwiferyserviceinruralAfghanistan
BackgroundAfghanistanhasoneofthehighestmaternalmortalityratios(MMR)intheworld.Onlyaminorityofthewomenhaveaccesstoaskilledbirthattendantandmostwomenaregivingbirthattendedbyatraditionalbirthattendant. Since2012NorwegianorganizationshavesupportedtheeducationofcommunitymidwivesinAfghanistan.
Theaimofthisstudyistoexplorewomen´sperception,utilizationandexperienceofprofessionalmidwiferycareinthetimearoundchildbirthintwoprovincesofAfghanistan
TrudeThommesen1,2,,Hallgeir Kismul1, AbdulHabibWakilzad3, KhadijaSafi3, IanKaplan3, Terje M.Watterdal31.CentreforInternationalHealth,DepartmentforGlobalPublicHealthandPrimaryCare,UniversityofBergen,Norway2.DepartmentofObstetricsandGynaecology, Haukeland UniversityHospital,UniversityofBergen,Norway3.NorwegianAfghanistanCommittee,Kabul,Afghanistan
AcknowledgementsWewouldliketothankallthewomenandmidwives intheprovincesKunar andLaghman whoparticipatedinthisstudy,aswellastheirmothers,sistersandmothers-in-laws
MethodologyAnexplorativecasestudyapproachwasadopted.Inadditiontoparticipatoryobservation,14in-depthinterviewsandfourFocusGroupDiscussionswereperformedwithalltogether39womenwhohadgivenbirthduringthelastsixmonths,mothers-in-lawsaswellascommunitymidwivesintheprovincesKunar andLaghman.Datawereanalysedthroughathematiccontentanalysis
FindingsThewomenexpressedthatthemidwives´ levelofknowledge,care,skillsandabilitytosaveliveswereimportantreasonsforgivingbirthinaclinic.Theyappreciatedthemidwives’actionstopromoteimmediateskin-to-skincontactandearlybreastfeeding.Lackofpermissionfromtheirrelativestovisittheclinicsandproblemswithtransportweresomeoftheobstaclesforusingthehealthfacilities
ConclusionEducationanddeploymentofprofessionalmidwivesseemtoimpacttheuseofmidwiferyserviceandimprovementofmaternalandinfantmorbidityandmortalityinruralAfghanistan
“Ihadthreechildrenathomewithalotofproblems.Myneighbouradvisedmetogototheclinic[..].WhenIwenttherethemidwivesbehavedsowellandIwasveryhappyandsatisfied.AfterthedeliveryIhadaveryseriousbleeding.Howeverthemidwifehelpedmeandgavememedicine.OtherwiseIcouldhavelostmylife”(Khandan,30)
