The instructive example of Afghanistan

 17-May-16, The Lancet

In The Lancet Global Health, Nadia Akseer and colleagues document the fairly positive maternal and child health outcomes achieved in Afghanistan over the course of a little over a decade. The global health community is grappling with the lessons learned from the Millennium Development Goal period and also with the outcomes of several Ebola-related reviews. 

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A message common to many of these reviews is that, unless we find ways to build functional health systems in fragile and failed states, it will be harder to make further progress on key global goals, such as the reduction of maternal and child mortality, as well as to protect the world from new infectious disease outbreaks.

After many decades of conflict and instability and the reign of the Taliban, which had sought to impose a very strict interpretation of Islamic laws on the country, by the end of 2001, the human and physical infrastructure of the country was in ruins. 

Importantly, the Ministry of Health and partners recognised that maternal mortality was a key priority in its own right and that it would become a key gauge of the overall functionality of the health system. This recognition led to a major focus on recruitment, training, and deployment of community-level midwives.

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