The New York Times profiles Pashtoon Azfar, the director of Afghanistan’s Institute of Health Sciences, who works for a nonprofit group from Johns Hopkins University that focuses on women and children’s health, and “also manages to serve as president of the Afghan Midwives Association.” Azfar was the “star” of a recent Capitol Hill briefing about maternal health in Afghanistan.

Despite Afghanistan having “the world’s second-highest death rate in women during pregnancy and childbirth,” at the briefing Azfar “ran through statistics showing notable increases recently in the country’s number of midwives, their education and the percentage of women who give birth with the help of a ‘skilled attendant,’ usually a midwife. The U.S., the World Bank, the European Commission, UNICEF, the Hopkins group (known as Jhpiego) and other donors have all helped Afghanistan’s Ministry of Public Health to make improvements,” according to the New York Times.

Although there has been some progress, “there is a long way to go,” the New York Times writes, noting that up to 80 percent of women in Afghanistan “still give birth without skilled help, and only a third receive any medical care at all during pregnancy.” The country’s problems “mirror those of many other poor countries,” while “deeper problems are cultural, rooted in the low status of women and the misperception that deaths in childbirth are inevitable,” according to the newspaper. 

After leaving Afghanistan for more than a decade, Afzar said when she returned in 2003, the state of midwifery was a mess. “A culture of war was going on,” Azfar said, adding, “If a mother came for delivery they didn’t treat her as she deserved or needed to be treated. There was no emotional support.” She “acknowledged that it was hard to change attitudes, but she insisted that it could be done, by making ‘interpersonal skills’ part of the training and the tests that students must pass to be allowed to practice,” writes the New York Times. The article includes more detail about Azfar’s life and early training (Grady, 7/27).