Kristina Krivats Arba
Tallinn Health Care College, Estonia
Title: Improving Afghanistan midwifery - professional activities during antenatal care, labour and postpartum in North and East Afghanistan: based on interviews during professional training for Afghan midwives in Estonia, Tallinn Health Care College
Biography
Biography: Kristina Krivats Arba
Abstract
Background: The research is carried out in the framework of the development project: improving quality of medical and info-technological education in North and East Afghanistan in 2014-2016. Afghan women's health indicators vary significantly from global standards. Afghanistan’s maternal mortality rate was second highest in the world. Neonatal mortality was 60 deaths per 1,000 live births in 2002. By 2010, the maternal mortality rate had reduced to 327 deaths per 100,000 live births. The rate of educated midwives in Afghanistan is still insufficient. The shortage of skilled birth attendants has been a key factor in the high maternal and newborn mortality in Afghanistan. Efforts to strengthen midwifery pre-service education in Afghanistan have increased the number of midwives from 467 in 2002 to 2954 in 2010.
Purpose: To describe and find out factors which impact midwifery professional activities during antenatal care, labour and postpartum in North and East Afghanistan and how to improve medical and info-technological education to target group.
Design: The research method is qualitative, based on semi-structured interviews. The target group was nine Afghan midwives from North and East Afghanistan. The questionnaire consisted of questions which were divided into three themes: antenatal care, labour and the postpartum period. The interviews were carried out in Tallinn Health Care College. Interviews were conducted in the English language and recorded on video. The interview was voluntary, and the anonymity of the participants was guaranteed. The results were transcribed, processed and analysed.
Findings: Antenatal care, labour, and the postpartum period affect the most cultural and religious beliefs and the standards prevailing in the society. Antenatal care, labour and postpartum period were often reported to be underused, even when available. In the cities the midwife assistance was more accessible. Midwives recommend go to a hospital to give birth, speaking about the risks of labour at home. There was limited and uneven understandings of the importance of antenatal care and impact the risks to labour and the post-natal period. Afghan midwives require modern and evidence-based training what is based on accepted guidelines, medical and info-technological education. The project needs to continue.