How afghanistan improved its health in 10 years despite bombs and bullets business standard news electricity symbols and units

Coverage of several maternal care interventions increased: Antenatal care–care during pregnancy–increased from 16% to 53%, births assisted by a skilled birth attendant from 14% to 46%, and births in a health facility from 13% to 39%. Childhood vaccinations doubled from 40% to 80% during this time.

The reduction in stunting has a lot to do with the health ministry’s focus on early breastfeeding and convergence of various ministries and aid agencies to achieve the goal, according to Homayoun Ludin, director of public nutrition, Ministry of Public Health.

It started in 2002, and we established the public nutrition department under the ministry of public health. For a few years, there was no clear understanding of how to achieve the targets. Then we organised one of the nutrition conferences in Kabul–South Asia Breastfeeding Forum in 2006.

Our minister and deputy minister and those involved in nutrition were mobilised on how to achieve specific actions, especially those which were well-studied like breast feeding, child feeding, complementary feeding and maternal feeding and initiatives like baby-friendly and mother-friendly ‘huspatal’ [hospital].

When we did not achieve our goals as we wanted or expected to achieve, we decided this is not just a health issue, and we need to involve other ministries as well. We developed another agenda–food security and nutrition–which is now shared with the general director of the council of ministries, which is the coordinating body of all ministries.

After the chief executive officer (CEO) of our government released the names for all these ministries, we had a big gathering in 2017. During the day, ministries were called on to develop their plan. Each month, they meet and prepare a plan. We have another meeting called the executive committee meeting and a high level steering meeting in six months where all ministers of the 17 ministries under the leadership of the CEO review the action points of each executive committee for the next six months.

Each ministry has specific terms of reference under nutrition and we have a specific advocacy meeting for each ministry. For example, ministry of rural rehabilitation and ministry of water and sanitation all have a part to play in nutrition. The ministry of education has integrated nutrition topics into the curriculum. The ministry of higher education has established nutrition departments in universities.

As most people follow religious leaders, we have close coordination with the ministry of religious affairs, which work with religious leaders on the importance of nutrition taking references mentioned in Koran. Now they [religious leaders] speak about nutrition in their speeches during different occasions. It shows the coordination and multi-sectoral approach.

As breastfeeding is fundamental for health and nutrition, whenever a mother is planning to have a baby, we train mothers about the importance of their [own] health. Religious leaders back the members in their community to support the efforts of mothers to have healthy babies.

First, we support women during the nine months of pregnancy, and we expect well-nourished baby to be around 3.5 kg during pregnancy. After two years, we expect appropriate height and weight… we have kept 86 cm height as our target after the completion of two years.

Breastfeeding is very important for the baby to be well nourished, and it is equally important for mothers to prevent breast cancer and ovarian cancer. We are supporting maternal nutrition during six months of exclusive breastfeeding when there is no chance of treating babies for anaemia.

In our society, whenever a man is talking, they [people], and even religious leaders, accept it. Just a few weeks back, I made a presentation to 200 religious leaders, including representatives from the ministry of religious affairs. I spoke at length about six verses of Koran [that support breastfeeding], and they accepted it.

When men come for Friday religious gatherings, they [religious leaders] convey this to them for their wives because it is difficult to speak to women since they don’t come out of the house or visit health facilities even when there are problems.

If we are monitoring growth or weighing a child or measuring the length of the baby, we need to inform mothers that the baby’s height should be 86 cm after six months. If your baby is less than 86 cm after six months, your baby is malnourished.

It is mainly in two parts: Whenever a baby is born in the hospital, we will tell the mother to start early initiation of breastfeeding within one hour since support is available. A midwife or nurse will support the mother, and if there are issues like attachment or position issues, they can help them.