Raising Institutional Delivery in War-Torn Communities: Experience of BRAC in Afghanistan


Hadi, A., T. Rahman, D. Khuram, J. Ahmed, and A. Alam. 2007. “Raising Institutional Delivery in War-Torn Communities: Experience of BRAC in Afghanistan.” Asia Pacific Family Medicine 6: 1–9.

Authors: A. Hadi , T. Rahman, D. Khuram, J. Ahmed, A. Alam


Aims: Although reproductive health services have been expanded in rural communities in Afghanistan in the last several years, no systematic attempt has been made to assess their contribution to promote safe delivery. This study assesses the effects of the Bangladesh Rural Advancement Committee (a non-government organisation) health programme in raising institutional delivery in post-conflict traditional communities in Afghanistan.

MethodsData for this study came from two surveys conducted by Management Science of Health/United States Agency of International Development in 2004 and 2006 in the district of Paghman in Kabul province. A total of 180 randomly selected married women who gave birth in the last 2 years preceding the survey were interviewed.

ResultsFindings reveal that institutional delivery in rural communities has been increasing even in post-conflict poor rural communities. The use of services was much higher if antenatal care was provided by midwives and physicians. Intensive community mobilization, provision of free services and transport facilities at night, incentives to health providers, maintaining privacy in the delivery room and the quality of services were the key factors in raising the number of institutional deliveries.

ConclusionsThe provisions of free services and incentives for health providers worked well in raising the frequency institutional delivery. Given that Afghan communities are sparsely distributed in the countryside and largely inaccessible by most modern transport, the expansion of this approach to provide institutional delivery may not be feasible at this stage. This study argues for the promotion of new approaches to maternal health by testing the cost-effective intervention models. The study concludes that an integrated approach to address health services can significantly improve access to and the utilization of institutional delivery among poor and disadvantaged communities in Afghanistan.

Topics: Armed Conflict, Gender, Women, Health, Reproductive Health, International Organizations Regions: Asia, South Asia Countries: Afghanistan

Year: 2007

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