Researching maternal mortality rates in Afghanistan
Hayes, W. C., & Darcy, N. (2011, May). Researching maternal mortality rates in Afghanistan. Presented at AAPOR 65th Annual Conference, Chicago, IL, May 13-16, .
This paper focuses on processes used and unique challenges in implementing data collection in a maternity hospital in Afghanistan. It addresses the unique challenges presented by working on the private
and sensitive topic of childbirth and accurately measuring training program results and post training implementation in an environment where armed conflict and gender-related political violence is common. The United States Department of Health and Human Services (DHHS) contracted RTI International to conduct an evaluation of two training programs of the Afghanistan Health Initiative (AHI) implemented at the Rabia Balkhi Maternity Hospital (RBH) in Kabul. The AHI purpose at RBH was to improve the quality of maternal and newborn care through in-service training and systems strengthening. Afghanistan has one of the highest maternal mortality rates in the world. Preventable complications related to childbirth cause more than 85 percent of deaths among women of childbearing age in
Afghanistan. D3 research indicates that 25% of Afghan women have their first child before the age of 18, and one in three women believe they have been denied healthcare due to their gender. The evaluation focused on clinical and hospital management training at RBH. RTI International led the
evaluation design and partnered with D3 Systems to conduct data collection activities at the RBH facility. Several instruments were designed and adapted by RTI including an evaluation to assess the knowledge,
skills and attitudes of the medical providers at RBH. RTI and D3 Systems’ medically trained Afghan staff conducted clinical observations, qualitative interviews, a facility audit and observation of clinical trainers. These staff, who were mostly female, provided valuable insight into the practicalities of completing research in this unique context.