In the immediate post conflict period,Afghanistan's health services were in a deplorable andchaotic state. Access and utilization of reproductive healthservices and skilled care during pregnancy, childbirth, andthe first month after delivery are key to saving those womenat risk of dying due to pregnancy and childbirthcomplications. In a society where women seek care only fromfemale providers, one barrier to expansion of services wasthe lack of qualified female health workers who could bedeployed to remote health facilities. Very few midwives whohad trained in Kabul or other big cities were willing towork in rural areas, and there were no education facilitiesand too few female school graduates who could be trained inthe provinces. As maternal health was one of the toppriorities of the health sector, the shortage of midwives toprovide reproductive health services had to be tackledurgently. Hence the Community Midwifery Education (CME)Program was created. The program aimed not only to trainmore midwives, but also to ensure both their initialdeployment in remote health facilities as well as goodretention rates. These aims were realized through thecreation of a new health cadre known as "communitymidwives," along with new competency-based curricula;establishment of CME schools in each province; relaxation ofthe admission criteria for students; and establishment of astrong accreditation board to ensure qualified midwives weretrained by the program. The program's success isattributed to stakeholder strong engagement, equity, andstrengthened human resource for health. The program shouldbe expanded to address thecontinuing shortage of midwives.The Mnistry of Public Health considers the program asuccessful intervention and believes that there is greatpotential to replicate this model to train other healthprofessionals and tackle the shortage of other humanresources for health.
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