Reducing maternal mortality in Afghanistan by training skilled attendants.

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An International Outreach Award, granted by the Royal College of Midwives (UK) has been gained by Scottish midwife Sheena Currie, who is co-ordinating a pilot Community Midwifery Training programme in Afghanistan for the Netherlands-based organisation HealthNet International (previously reported in International Midwifery, May/June 2003; 16: 32). The award acknowledges innovation and development in midwifery practice and the contribution of training midwives to expanding the Health Workforce in postconflict Afghanistan.

In less than two years since the launch of the programme, 24 midwives have been trained and deployed to work in the rural areas of the Eastern Region of Afghanistan. These are the first trained female staff of their kind in a country that still places severe restrictions on the education and employment of women. The move thus represents a milestone in Afghanistan's development and reconstruction.

One of the major innovations of the training programme is that, in comparison with conventional urban-based midwifery training programmes, the students come from rural districts and are selected and supported by their own communities. During their training they have clinical placements in the rural health facilities in which they will work once qualified. This makes them highly motivated to return to their home districts and strengthens their relationship with their community.

The pilot community midwifery training has been so successful that the Ministry of Health of Afghanistan has now adopted it as one of their national strategies to reducing maternal...