ICM’s Statement on Afghanistan

Photo: Former president of the Afghan Midwives Association Zahra Mizraei fled Afghanistan when the Taliban took over, and is now in a camp in Spain. Photograph: Katie Cox/The Guardian

The midwives of Afghanistan have long-since stood as a beacon of resilience and perseverance for our global midwife community. In the face of conflict, a global pandemic and often staunch opposition to women’s rights and sexual and reproductive autonomy, Afghan Midwives Association have worked tirelessly to advocate for the rights of women and their families and improve access to quality care for all Afghan people.

Earlier this year, Afghan Midwives Association in Afghanistan succeeded in opening the country’s first-ever midwife-led birthing centre in Kabul, symbolising significant progress for quality midwifery services and women’s rights. We are saddened that recent events have resulted in the closure of this facility and the further marginalisation of midwives and the women and girls they care for.

Since mid-September 2021, ICM team members, including our Chief Executive, President and Board Member representing the Eastern Mediterranean Region, have communicated with Afghan Midwives Association Leadership Board and Chief Executive Director in Afghanistan to understand and discuss the realities of midwives and their efforts to deliver sexual and reproductive health services. These conversations have unveiled the following, deeply concerning trends:

• Financial aid from the international community has altogether stopped, leaving major gaps in Afghanistan’s economy, including within its health sector. Midwives and other care providers have reported a dramatic scarcity of healthcare supplies, aggravated by the closure of healthcare facilities and existing staff shortages.
• Where Afghanistan’s maternal mortality ratio was already among the highest in the world, midwives are observing an increase in preventable maternal and newborn death. As Afghan midwives and other on-the-ground advocates highlight, this increase is the result of many factors, including the realities of living in a state that actively defunds and deprioritises women.
• Midwives, all of whom are women in Afghanistan, have been unable to provide timely and responsive care as a result of the limited authority they have over their own movements and decision-making.

Despite these dangerous circumstances, Afghan midwives have continually put their own lives and safety at risk in an attempt to uphold care for birthing women and newborns. Importantly, midwives and other healthcare professionals are providing this care with little or no compensation. We fear this current trajectory will inevitably contribute to a devastating and long-lasting humanitarian crisis, disproportionately impacting women and girls.

ICM echoes like-minded statements released by our global partners, such as the PMNCH’s recently published call for all actors to commit to the urgent and unwavering protection of women, children and adolescents, and we call on our global community to take action to re-establish funding for maternal and newborn health services in Afghanistan. We will continue to promote these rights and come together with our partners and member associations to stand in solidarity with midwives and all citizens of Afghanistan in this time of need.