Training Midwives in Afghanistan

Midwives in Afghanistan are on the front lines of a deepening maternal health crisis. Through this project, Action for Development strengthened both service delivery and professional training to ensure women in North Kabul - who cannot easily reach a maternity home due to distance and centeral maternity homes being overcrowded - can access safe, skilled care during pregnancy and childbirth.

In 2024, we launched a dedicated inpatient midwife-led maternity unit within our Comprehensive Health Centre, creating safe, clean, and well-equipped space for antenatal care, postnatal care, and normal deliveries. Since opening, the unit has supported over 735 women with antenatal care, 281 women with postnatal care, and safely delivered 15 babies, while referring complicated cases to government hospitals to ensure patient safety.

"It was midnight, I woke up from pain, and I understood that it was time to go to a hospital for delivery. My husband asked our neighbor to borrow their car - which was lackily available, and they took us to Maternity hospital in center of Kabul. They told me that I was to deliver in about 2 hours - and they will check on my again. I went into the post partum unit to leave my bag and secure a bed. There was no empty bed, on each bed 2 women were laying with their babies in their arms. The bedsheets were dirty and all midwives were occupied with overwealmeing number of patients. I sat on a chair, but after 1 hour i got up and went to see if I could get an attention of a midwive or a doctor. it was 3 am, the the doctor was no where to be seen. 4 men brougth a woman, laying on a balanket, with a river of blood streaming under her. An accompanying women screamed for help - and two midwives run toward the newly arrived patient, we all women in the corridor of the hospital awaiting our turn - sorrounded her, she was pale and in coma. The accompanying woman explained that she gave birth at home but they could not pull out placenta. This was one of my nightmares... I was standing still and did not know what to do, and if this would happen to me - what should I do? I am RH negtive. Another older woman accompanying her daughter at the hospital told me:" daughter, if you have time left leave this hospital and seek help somewhere else. There is not enought staff to help you... it is better for you to find a calmer place..." I called my friend and woke her up  to ask she would know of a place for me to go... she gave me the address of the clinic,. I came here - it was almost 5 am... I gave birth at about 7:30, to a daughter. I was happy to find a calm corner and to have these nice midwives who can really provide a patient centered care. I am grateful to know this clinic exist. "

This was a testimonial of one of our patients, at the clinic. 

The need for skilled midwives has grown significantly as many trained health professionals have left Afghanistan in recent years. In response, we delivered an intensive 10-day midwifery training program to 41 midwives from 20 health facilities across Kabul and neighboring provinces. The training focused on essential lifesaving skills, including newborn resuscitation, management of postpartum hemorrhage, pre-eclampsia and eclampsia care, infection prevention, breastfeeding support, maternal mental health, and family planning. Every participating midwife successfully completed the course and certification process.

The results were measurable and encouraging. Post-training assessments showed an average increase of 46% to 50.5% in knowledge and confidence across key clinical areas. Even more importantly, each trained midwife returned to her home facility and cascaded the learning to 1–3 additional colleagues—extending the project’s reach to more than 140 midwives in total. In a context where access to ongoing professional development has become increasingly restricted, this cascade model is helping sustain skills, strengthen peer networks, and expand impact far beyond the training room.

Despite ongoing challenges—including funding pressures, staff migration, and evolving regulations—this project demonstrates that local midwives remain deeply committed to serving their communities. Women consistently report choosing our facility because of the respectful care, cleanliness, affordability, and trust they feel with our staff. With your continued support, we can sustain and expand this vital work—ensuring more Afghan women have access to safe motherhood services and more midwives have the skills they need to save lives.