Renewing the promise for maternal and child survival in Afghanistan

Dr. Malalai Naziri, a Maternal and Child Health Officer in Afghanistan, has seen the difference that cost-effective, high-impact interventions can make to reduce maternal mortality, as well as newborn, infant, and child mortality.

She recently told me about a young 22-year-old mother from Logar province in eastern Afghanistan, whose first two babies died at full term in utero, due to foetal distress.

Fortunately, the young mother finally went on to deliver a healthy baby girl at Kabul Hospital following the introduction of health facility protocols that mandated the use of a partograph in the management of labour.

This low-cost tool monitors key indicators during labour including, among other things, the heart rate and blood pressure of both mother and baby. This in turn allows for timely decision-making and interventions by health providers before complications arise.

The support provided to the mother to breastfeed her newborn daughter within the first hour of delivery and to give her adequate warmth, was also critical to saving the infant’s life.

Stories like this are positive signs of progress in Afghanistan and, thanks to government commitment, partner support and community engagement, the future is looking brighter for millions of mothers and children across Afghanistan.

This past week in Kabul, it was also truly inspiring to see over 350 representatives of government, the UN, development partners, and civil society, come together to make, what I believe will be, a profound difference in the lives of Afghan mothers and children.

The ‘Call to Action’ conference, which culminated in the Kabul Declaration, was an intense and strategic moment, benefiting from national and international expertise, to accelerate progress towards reducing maternal, under-5 and infant mortality in Afghanistan, and to save an additional 35,000 lives over the next five years under the banner of A Promise Renewed.

The aim is to build on the success of the past 25 years: between 1990 and 2013, the number of Afghan children dying before the age of 5 decreased by 46 per cent. The number of newborns dying within the first 28 days declined by 29 per cent. The number of mothers dying due to complications from pregnancy or childbirth also decreased, and a greater number of women now access health care services.

An Afghan girl receives two drops of polio vaccine during the National Immunization Days in 2013.
An Afghan girl receives two drops of polio vaccine during the National Immunization Days in 2013. © UNICEF/AFGA2013-00017/Froutan

Immunization is another important, high-impact intervention which has ensured that at least 60 per cent of Afghan children are fully protected against preventable deadly diseases. By improving and maintaining health systems, and providing vital immunization services, even in hard-to-reach areas, the lives of children and mothers are saved every day.

But there is much more still to be done. The fact that one child in every ten in Afghanistan dies before they reach their fifth birthday is wholly unacceptable. The fact that most Afghan women, and especially those in remote areas, do not have access to health care services, must change.

In organising the ‘Call to Action’ conference with the Ministry of Public Health, USAID, and Aga Khan University, UNICEF is helping to improve dialogue and partnerships – not only amongst ourselves, civil society and the private sector – but also with communities, children, adolescents and young people.

Renewing the promise is just the start of a long road ahead – but it is a road to a defined goal. 2020 is just five years away and with this commitment, under the leadership of the National Unity Government, we will work together for an equitable assurance of health rights – especially for the disadvantaged, marginalized, the hard-to-reach and the poor.

We are working not only with communities and families in the Afghan society of today, but for children and future generations in Afghanistan who legitimately demand from all of us, that we translate these promises into reality.

Akhil Iyer is the UNICEF Representative in Afghanistan.

On 12 May 2015, in a new demonstration of commitment, the Afghanistan government, donor agencies, the UN and civil society signed the Kabul Declaration, renewing Commitment to Reduce Preventable Deaths among Women and Children by 2020. In launching this declaration, Afghanistan becomes the thirtieth country to launch A Promise Renewed

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