Increasing Access to Skilled care at birth in Afghanistan

1
Increasing Access to Skilled care at birth in
Afghanistan
2
Background

• 83 of home deliveries
• 8 of births attended by Skilled providers
• The Govt. is committed

3
Achievements

• RH Strategy is already developed and is in the
  implementation phase
• IMPAC as an EmOC manual is translated into both
  languages (Dari Pashto) and is used as a
  reference training manual
• An EmOC Working Group is now assigned to develop
  National Standards for EmOC

4
Achievements (Contd)

• These standards will address all issues related
  to EmOC services at National level
• Midwifery training Curriculum and Community
  Midwife Curriculum is developed and will be used
  at National levels

5
Increasing Access to Skilled care at birth during
home delivery

• Monitoring progress of labor (partograph)
• Identify fetal malposition
• To manage PPH (Prenteral Oxytocin)
• Parenteral administration of Anticonvalsants

6
Increasing Access to Skilled care at birth during
home delivery (Contd)

• Recognition of cervical tears and refer if
  detected
• Manual Removal Of Placenta
• Oral Antibiotics
• Refer Complications

7
EmOC Functions to be performed by SBA at the
Facility

• (preferably the activities in the first 2 slides
  should normally be done at the community level by
  SBAs)
• All above and
• Repairing of the Tears (vaginal and cervical)
• Assisted Vaginal Delivery(Vacuum extraction,
  Forceps delivery)
• IV infusion of Antibiotics
• IV infusion of Anticonvulants (Management of
  Eclampsia)

8
EmOC Functions to be performed by SBA at the
Facility (Contd)

• EC, and DC (management of abortion)
• Blood transfusion
• C-Section
• Hysterectomy
• Management of prolapsed cord shoulder dystocia
• Craniotomy