Women Making a Difference

Prevention of Postpartum Hemorrhage Program Reduces Maternal Death

	Gul Jamal displays prevention of postpartum hemorrhage educational materials. Source: USAID/Afghanistan/HSSP

Bibi Gul Jamal works tirelessly as a community health worker to improve the health of women in her village of Komak-e-Omar Khan in Jawzjan, a northern province of Afghanistan. A few years ago, Bibi tragically lost her two daughters when they died from excessive bleeding after childbirth. Both had experienced retained placenta, which is a common cause of postpartum bleeding. She lived far from the health facility and delivered at home without the assistance of a skilled provider.

“My heart is filled with the pain of losing my young daughters,” said Bibi. “No mother should ever suffer such pain.”

Like Bibi’s daughters, women in Afghanistan face an enormous risk of dying during pregnancy and following delivery. About one out of every eight Afghan women dies from causes related to pregnancy and childbirth each year. The most common cause of maternal mortality in Afghanistan is bleeding after delivery, otherwise known as postpartum hemorrhage. About 80 percent of postpartum hemorrhage cases can be prevented during labor and delivery. The vast majority of births in Afghanistan occur, however, without the assistance of a midwife or doctor – greatly increasing the risk of women dying from postpartum hemorrhage.

USAID’s Health Services Support Project (HSSP) is supporting the Ministry of Public Health to deliver community-based interventions that protect women from the risk of postpartum hemorrhage when delivering at home without assistance from a skilled provider. Community health workers are trained to identify and visit the homes of pregnant women in their communities. They educate the women about the importance of delivering with a skilled provider, danger signs in pregnancy and childbirth, and the main causes of postpartum hemorrhage and how it can be prevented. They also provide information about correct timing and use of the drug misoprostol to stop bleeding and distribute it to the women for use immediately after childbirth where there are no skilled providers.

In addition to the pregnant women in Komak-e-Omar Khan village, approximately 20,000 pregnant women will participate in the Prevention of Postpartum Hemorrhage Expansion Project in five of the most remote provinces of the country, where access to skilled care at delivery remains a substantial challenge.

The Ministry of Public Health, through USAID support, trained Bibi to visit pregnant women in her community to provide safe, acceptable, feasible, and effective interventions. Within three days of completing her training, Bibi registered eight pregnant women in her community.

Story provided by USAID/Afghanistan/Health Services Support Project

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