~~HealthProm is a UK-based NGO which aims to promote the health and social care of women, especially mothers, and vulnerable children. It prioritises safe motherhood because in pregnancy, childbirth and the postnatal period the least input can yield the greatest lifelong gain.

Based on the Afghan Mortality Survey 2010, a claim has been made that Afghanistan has achieved MDG 5a - to reduce maternal mortality by 75% - five years in advance. Such a decline, in such a short period, has never occurred in any developing country before. Although much good work has been done to reduce maternal mortality in Afghanistan, in a country struggling with insecurity, an underfunded health service and poor rural roads and transport many consider it too good to be true. The UN agencies have adjusted their estimate of maternal mortality to a figure close to the Afghan Mortality Survey figure.

Maternal mortality is a major indicator of an effective health service. If the Ministry of Public Health adheres to the Afghan Mortality Survey figure and UN agencies stick to their figure, we consider it likely that the international donors to the health service may reduce their funding at the donor conference due to be held in Brussels on 5 October 2016.

We have no new figure to propose. It is simply advisable that the maternal mortality ration (MMR) figure of the Afghan Mortality Survey 2010 should be reconsidered in the light of the difficulties encountered in carrying out the survey. A new survey would take much time and could not at present be undertaken in provinces where the level of armed conflict is high. It is especially advisable that the figure be revised before the Ministry starts to draw up its reproductive health policy, as that policy needs to have a baseline that is as accurate as possible.

At present many specialists, in and outside Afghanistan, consider the AMS 2010 results to be “too good to be true”, but nobody within Afghanistan says this. The doubts have been voiced abroad. A critical mass of support for revision of the figure from well informed Afghan specialists is needed. It is crucial that the maternal mortality figure should be reconsidered now. If this opportunity is lost, many more women than necessary will die from pregnancy related causes for many years to come.
Program Background:
The assignment is based on the paper titled, ‘Maternal mortality reported trends in Afghanistan: Too good to be true?’ published at http://www.baag.org.uk/resources/healthprombaag-maternal-mortality-reported-trends-afghanistan-too-good-be-true-december in November 2015 (attached as background document). See also an article in the New York Times of 4 December 2015 based on this paper at http://www.nytimes.com/2015/12/05/world/asia/afghanistan-maternal-mortality-rate.html?_r=0.

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