WUNRN
Presentation by Dr. Catherine d'Arcangues, Department of Reproductive Health and Research, World Health Organization,
UN Human Rights Council Session 17 Panel - 9 June 2011 - Geneva
AFGHANISTAN WOMEN & GIRLS - REALITIES & CHALLENGES
Indeed,
However, if we consider the
situation ten years ago:
- women were unable to work in most parts of
- not only were teachers, doctors and
nurses forced to stay at home, or work in secret - but no new educators and
health workers were being trained.
- the health system barely functioned in cities, let alone in the countryside - where most Afghans live.
As a result,
The maternal mortality ratio
was 1400 deaths per 100.000 live births, which translates into 50 maternal deaths
each day, or, for an individual woman, a risk of 1 in 11 for her to die of
maternal causes during her life time, one of the highest in the world.
As we known, the causes for
this are multiple: we know, for example
that only 14% of them had the help of a skilled attendant during birth, but it
is not just related to health care. It
is also a reflection of the low level of education of women who have a literacy
rate of 13%, compared with 43% among men.
It is also a reflection of early marriage, with over half of the women
married before the age of 18, and we know that pregnancies are more risky for
adolescent girls. It is also a
reflection of a very low use of contraception, with only 16% of women of
reproductive age using modern methods of contraception, and we know that
pregnancies that are too close or too numerous carry more risk.
But today, this is
changing. The situation is changing
slowly. But surely, for the better. Girls are in schools, midwives are being
trained, and women are working as teachers and health workers. In fact, a
Mortality Survey was carried out recently and preliminary results show that
maternal mortality is declining. We
expect the results to be released officially next month.
This reflects the high
priority given by the Government and its partners to maternal and child health
and several years of sustained effort.
WHO is one of those partners and our office has been providing support
in the field of family planning and community health. Just to give some examples, this has been in
the form of:
- situation analysis of family planning
- training of health personnel in
clinical care in reproductive health and in gender and rights issues
- training of trainers for reproductive health in
emergencies
- community-based projects to increase the adoption of family
planning
- operations research to facilitate the uptake of certain interventions
(haemoglobin color scale, use of the partograph).
Last September, the Government of Afghanistan renewed its commitment by pledging its support to the Global Strategy for Women's and Children's Health launched by Secretary General Ban Ki-Moon.
Specifically,
the Government pledged that it will
- increase public spending on health from $10.92 to at least
$15 per capita by 2020.
- increase the proportion of deliveries assisted by a
skilled professional from 24% to 75% through strategies such as increasing the
number of midwives from 2400 to 4556 and increasing the proportion of women
with access to emergency obstetric care to 80%.
- also improve access to health services ‐ strengthening outreach,
home visits, mobile health teams, and local health facilities.
- increase the use of contraception from 15% to 60%, the
coverage of childhood immunization programs to 95%, and universalize Integrated
Management of Childhood Illness.
WHO and its sister UN organizations are committed to supporting this action. Specifically, the group of H4+ which includes WHO, UNFPA, UNICEF, UNAIDS and the World Bank, is working alongside the Government of Afghanistan to implement a joint action plan to reduce maternal and newborn mortality.
This
joint plan has four main goals:
1.
to jointly mobilize funding and technical expertise
for multi-sectoral activities for reducing maternal and newborn mortality;
2.
to strengthen the Government’s capacity to provide
quality maternity and newborn care,
3.
to enhance women’s access to health care by
increasing the availability, affordability and acceptability of health care,
including outreach in the community, and
4.
to increase women’s ability to access resources for
care through education.
This
progress is encouraging but much hard work remains to be done.
This highlights the need for long-term engagement - and a willingness to focus on setting up and maintaining systems and infrastructure that last.
For this, we need to pull all forces together with the same vision.
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