Afghan women rebuild maternal healthcare amidst crisis

In Helmand and Farhan provinces of Afghanistan, women like Ram Bibi and Manawara are receiving prenatal and delivery care at family health houses (FHHs), locally known as Ashiana-e-Sehi.

These clinics, established in 2009 by the United Nations Population Fund (UNFPA), provide essential maternal and newborn care in a country considered dangerous for mothers and children.

A 2024 study revealed that less than one-third of Afghans can access healthcare, making these community-based clinics vital for many women who previously delivered at home without skilled assistance. These FHHs, serving populations of 1,500 to 4,000 people, are located in areas at least ten kilometers from the nearest basic health facility and staffed by locally recruited, trained midwives. While designed to serve 300 patients monthly, some clinics, like the one in Arkalik, now see up to 70 patients daily.

The International Planned Parenthood Federation found that nearly three-quarters of women surveyed lived within one kilometer of their local FHH, and 88.7 percent considered them very important for healthcare. Despite their success, with some clinics reporting zero maternal deaths in the last seven years, the FHHs face challenges. These include high patient loads, medicine shortages, a lack of trained staff, and restrictions on women’s movement requiring a male escort (Mahram).

To address these issues, UNFPA has introduced the Safe Delivery App, providing digital training and support to midwives, and has trained over 1,200 midwives to use it. The program currently relies heavily on external donor funding, but a new national health policy may offer increased support for community-level services.