Development of the Community Midwifery Education initiative and its influence on women’s health and empowerment in Afghanistan: a case study
详细信息 查看全文
- 作者：Elizabeth M Speakman ; Ahmad Shafi ; Egbert Sondorp ; Nooria Atta…
- 关键词：Policy analysis ; Midwifery ; Maternal health ; Afghanistan
- 刊名：BMC Women's Health
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：14
- 期：1
- 全文大小：535 KB
- 参考文献：1. Strong, L, Wali, A, Sondorp, E (2005) Health Policy in Afghanistan: two years of rapid change. London School of Hygiene & Tropical Medicine. pp. 8-9
2. Griffiths, J (2009) Afghanistan: land of conflict and beauty. Andre Deutsch Ltd, London
3. Bartlett, LA, Mawji, S, Whitehead, S, Crouse, C, Dalil, S, Ionete, D, Salama, P (2005) Where giving birth is a forecast of death: maternal mortality in four districts of Afghanistan, 1999-002. Lancet 365: pp. 864-870 in new window">CrossRef
4. Stanisei, K (2011) Medical education in Afghanistan. Afghan Medical Association of America, Afghan Medical Tribune.
5. Smith, JM, Currie, S, Azfar, P, Rahmanzai, AJ (2008) Establishment of an accreditation system for midwifery education in Afghanistan: maintaining quality during national expansion. Public health 122: pp. 558-567 in new window">CrossRef
Trends in Maternal Mortality 1990-2008: Estimates developed by WHO, UNICEF, UNFPA and The World Bank. World Health Organization, Geneva
Afghanistan National Health Resources Assessment. Management Sciences for Health, Management Sciences for Health/Europe, Health and Development Services (HANDS), MoPH, Accession/Record Number 7250/6321. Kabul
Historical data graphs per year 2012.
6. Roberts, B, Morgan, OW, Sultani, MG, Nyasulu, P, Rwebangila, S, Sondorp, E, Chandramohan, D, Checchi, F (2011) Economic feasibility of a new method to estimate mortality in crisis-affected and resource-poor settings. PloS one 6: pp. e25175 in new window">CrossRef
7. Marvi K, Howard N: Objects of temporary contraception: an exploratory study of women’s perspectives in Karachi, Pakistan. / BMJ Open 2013.,3(8): doi10.1136/bmjopen-2013-03279.2013
8. Palmer, N, Strong, L, Wali, A, Sondorp, E (2006) Contracting out health services in fragile states. Bmj 332: pp. 718-721 in new window">CrossRef
ICM international definition of the midwife.
Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO. World Health Organization, Geneva
9. Campbell, OM, Graham, WJ (2006) Strategies for reducing maternal mortality: getting on with what works. Lancet 368: pp. 1284-1299 in new window">CrossRef
The State of the World’s Midwifery 2014: a universal pathway. A woman’s right to health. UNFPA, New York, NY
10. Renfrew, MJ, McFadden, A, Bastos, MH, Campbell, J, Channon, AA, Cheung, NF, Silva, DR, Downe, S, Kennedy, HP, Malata, A, McCormick, F, Wick, L, Declercq, E (2014) Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. Lancet.
Fragile states 2013: Resource flows and trends in a shifting world. OECD/DAC International Network on Conflict and Fragility (INCAF), Paris
11. Walt, G, Shiffman, J, Schneider, H, Murray, SF, Brugha, R, Gilson, L (2008) “Doing-health policy analysis: methodological and conceptual reflections and challenges. Health policy and planning 23: pp. 308-317 in new window">CrossRef
12. Hsieh, H-F, Shannon, SE (2005) Three Approaches to Qualitative Content Analysis. Qualitative Health Research 15: pp. 1277-1288 in new window">CrossRef
13. Buse, K, Mays, N, Walt, G (2005) Making health policy. Open University Press, Maidenhead
Agreement on provisional arrangements in Afghanistan Pending the re-establishment of permanent government institutions.
14. Williams, C (2001) A quiet general fights for her nation. LA Times.
15. Howard, N, Woodward, A, Patel, D, Shafi, A, Oddy, L, Ter Veen, A, Atta, N, Sondorp, E, Roberts, B (2014) Perspectives on reproductive healthcare delivered through a basic package of health services in Afghanistan: a qualitative study. BMC Health Serv Res 14: pp. 359 in new window">CrossRef
16. Amowitz, LL, Reis, C, Iacopino, V (2002) Maternal mortality in Herat Province, Afghanistan, in 2002: an indicator of women’s human rights. JAMA 288: pp. 1284-1291- 刊物主题：Gynecology; Maternal and Child Health; Reproductive Medicine;
- 出版者：BioMed Central
- ISSN：1472-6874
文摘
Background Political transition in Afghanistan enabled reconstruction of the destroyed health system. Maternal health was prioritised due to political will and historically high mortality. However, severe shortages of skilled birth attendants - particularly in rural areas - hampered safe motherhood initiatives. The Community Midwifery Education (CME) programme began training rural midwives in 2002, scaling-up nationally in 2005. Methods This case study analyses CME development and implementation to help determine successes and challenges. Data were collected through documentary review and key informant interviews. Content analysis was informed by Walt and Gilson’s policy triangle framework. Results The CME programme has contributed to consistently positive indicators, including up to a 1273/100,000 reduction in maternal mortality ratios, up to a 28% increase in skilled deliveries, and a six-fold increase in qualified midwives since 2002. Begun as a small pilot, CME has gained support of international donors, the Afghan government, and civil society. Conclusion CME is considered by stakeholders to be a positive model for promoting women’s education, employment, and health. However, its future is threatened by insecurity, corruption, lack of regulation, and funding uncertainties. Strategic planning and resource mobilisation are required for it to achieve its potential of transforming maternal healthcare in Afghanistan.