Grim infant and maternal mortality rates have been regularly cited as evidence of Afghanistan's backwardness after decades of war, and of the slow progress of the internationally funded reconstruction effort.

According to the preliminary results a Johns Hopkins University study, the infant mortality rate has declined to about 135 per 1,000 live births in 2006, from an estimated 165 per 1,000 in 2001.

The researchers "found improvements in virtually all aspects of care in almost every province," the Public Health Ministry and World Bank said Thursday in a joint statement on the findings.

"Despite many challenges, there are clear signs of health sector recovery and progress throughout the country," said Public Health Minister Mohammad Amin Fatimi. "But there is a long way to go to provide access to basic health services for Afghans in far remote, underserved and marginalized areas across the country."

The researchers studied more than 600 health facilities annually since 2004.

They also checked more than 8,000 households and found that the number of women receiving prenatal care increased to 30% in 2006 from from 5% in 2003.

Nineteen percent of pregnant women were attended by a skilled health worker last year, up from only 5% in 2003.

The ministry is working to set up small clinics, deploy mobile teams in remote rural areas, expand community midwifery training, and increase the number of female staff at health facilities.

Afghanistan has one of the world's highest maternal mortality rates. One in 60 Afghan women dies of pregnancy-related causes, said U.N. Population Fund executive director Thoraya Ahmed Obaid.

"No woman should die giving life," Obaid said during a visit to Afghanistan this week. "No nation can be developed when its women are dying giving birth."

Obaid encouraged Afghan women to leave several years between the birth of each child to reduce the risk to themselves.