OVERVIEW

The USAID HEMAYAT project seeks to increase the utilization of high-quality family planning (FP) and maternal and newborn health (MNH) services through the introduction and scaling-up of culturally appropriate, cost-effective, high impact interventions that strengthen and enhance existing primary care services provided through the Basic Package of Health Services (BPHS) and the private sector. HEMAYAT targets five densely populated provinces: Balkh, Herat, Kabul, Kandahar, and Nangarhar. Using the "3 delay model,” HEMAYAT has realigned activities to address the leading causes of maternal and newborn deaths.

ACTIVITIES

• Scale up high-impact interventions focusing on “better care on the day of birth.”
• Establish Khana-e-Qabila (private ‘midwife’s house’ linked with the Basic Package of Health Services for reporting and referral purposes) to standardize services provided by private sector solo-practice midwives
• Support community health workers to provide an integrated package of high impact interventions
• Strengthen integration of gender and respectful care in FP/MNCH guidelines and protocols
• Increase access, utilization, and demand for health services through the use and scaling up of Information and Communication Technology (ICT) and other innovations
• Strengthen the referral system between the BPHS, the Essential Package of Hospital Services (EPHS), and the private sector, including increased use of an established regulatory mechanism for midwives and nurses; implement an integrated, whole of team, on-site mentoring program to improve the quality of care

ACCOMPLISHMENTS

• Supported the Ministry of Public Health to develop and implement a national scale-up plan to distribute and utilize chlorhexidine (an antiseptic, antibacterial agent) for use on newborn umbilical cords to prevent sepsis; one year later, over 79,000 newborns received chlorhexidine umbilical cord care
• Expanded the range of FP methods through the introduction of Sayana Press in Afghanistan and into the MoPH’s essential medicine list; Sayana Press is a pre-filled uniject (single injection) that enables women to self-administer the birth spacing medicine without health worker’s assistance
• Established 25 Khana-e-Qabilas (midwife houses) in Balkh, Herat, and Kandahar provinces by equipping solo practicing midwives with the necessary skills and tools to deliver quality services
• Proportion of women who delivered at the 53 targeted health facilities and received a uterotonic to prevent post-partum bleeding increased from 86 percent (April 2018) to 94 percent (September 2018), indicating a significant improvement in quality of care
• Launched the Mobile Alliance for Maternal Action pilot program to increase awareness and shift behaviors through phone-based dissemination of voice and text messages; 2,616 pregnant women were registered in the program by December 2018
• In June 2018, the Afghanistan Midwives and Nurses Council received Presidential Cabinet approval as an established and independent government entity and was officially launched in December 2018