Healthcare and Education
Afghans are in need of high quality, culturally sensitive health care and health education that is easily accessible by all people. Afghanistan continues to have one of the highest rates of infant mortality and maternal death. The country has low life expectancy and too high malnutrition rates. AIL addresses these problems by providing health services combined with health education through fixed clinics, mobile clinic outreach and Community Health Worker Posts.
Patients always receive education about health topics including subjects unrelated to their current ailment or health matter. In addition, AIL runs in depth workshops on health topics that can be a few hours to a few days in length. This innovative linkage of health treatment with comprehensive health education is effective in breaking cycles of ill health that plague families. The health of the Afghan people as a whole is improving not just through the provision of health care services but critically through the spread of knowledge about health to ordinary people. The people are willing to learn and to change old habits once they have been educated about disease, germs, viruses, how to stay healthy and the benefits of hygiene, vaccinations and preventive care.
Patients always receive education about health topics including subjects unrelated to their current ailment or health matter. In addition, AIL runs in depth workshops on health topics that can be a few hours to a few days in length. This innovative linkage of health treatment with comprehensive health education is effective in breaking cycles of ill health that plague families. The health of the Afghan people as a whole is improving not just through the provision of health care services but critically through the spread of knowledge about health to ordinary people. The people are willing to learn and to change old habits once they have been educated about disease, germs, viruses, how to stay healthy and the benefits of hygiene, vaccinations and preventive care.
Patient care
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Clinics
AIL has four clinics in Afghanistan, two in Kabul Province and two in Herat Province. Both clinics provide medical treatment and health education to patients with a particular focus on reproductive health services and education. The clinics treat numerous ailments from colds to injuries and diseases as well as preventative care like vaccinations. The clinics routinely assess children for nutritional status and run Intensive Nutrition Programs for the most needy. The latter program provides food, information on nutrition and cooking instruction. Some clinics do cooking on site and children are fed which creates added incentive for return visits. All the clinics see high levels of returnee patients as people receive good care and trust AIL so return when they have other medical needs. |
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The Community Health Worker Program
Working with the Herat Ministry of Health, AIL runs Community Health Worker (CHW) posts training the workers and supporting them. Each CHW team has two members, a male and female. They are chosen by the villagers, work at the village level and have some level of education. In some cases, the female members have been educated at AIL centers to prepare for their job. The basic CHW training takes several months and after this they meet monthly with clinic staff and are given additional refresher training when needed. AIL also holds more in depth CHW training to update workers on medical advances and the latest disease concerns.
CHWs give first aid, provide contraceptives that have been prescribed through the clinic, care for pregnant women, work with malnourished children and their mothers and give health education as well as referring villagers to clinics . The CHW program has been very successful in being a point of triage taking care of some things that do not need clinic care. This has relieved clinic numbers as well as spreading health education which helps prevent illness in the first place. The CHWs are the closest to the people in the community and are most likely to know when there is a health situation that needs to be referred to a clinic, even when the patient does not initially seek their help. Since they are trusted local people patients are more likely to seek further medical treatment with their recommendation which is a great help in these rural communities. CHWs are a great early intervention resource and help to prevent health problems reaching crisis levels for families.
Working with the Herat Ministry of Health, AIL runs Community Health Worker (CHW) posts training the workers and supporting them. Each CHW team has two members, a male and female. They are chosen by the villagers, work at the village level and have some level of education. In some cases, the female members have been educated at AIL centers to prepare for their job. The basic CHW training takes several months and after this they meet monthly with clinic staff and are given additional refresher training when needed. AIL also holds more in depth CHW training to update workers on medical advances and the latest disease concerns.
CHWs give first aid, provide contraceptives that have been prescribed through the clinic, care for pregnant women, work with malnourished children and their mothers and give health education as well as referring villagers to clinics . The CHW program has been very successful in being a point of triage taking care of some things that do not need clinic care. This has relieved clinic numbers as well as spreading health education which helps prevent illness in the first place. The CHWs are the closest to the people in the community and are most likely to know when there is a health situation that needs to be referred to a clinic, even when the patient does not initially seek their help. Since they are trusted local people patients are more likely to seek further medical treatment with their recommendation which is a great help in these rural communities. CHWs are a great early intervention resource and help to prevent health problems reaching crisis levels for families.
MIRA
In 2017, AIL has started using the MIRA program. AIL was selected to use this program at its two Herat clinics which support 14 CHW health posts. MIRA was started in India and is a mobile phone based health monitoring system. The system was designed to help pregnant women and their medical caregivers to better evaluate pregnancy progress and dispense health information. To start the program AIL had to buy the necessary equipment and phones and translate the manuals into Farsi, as well as preparing registration forms and data collection procedures.
In 2017, AIL has started using the MIRA program. AIL was selected to use this program at its two Herat clinics which support 14 CHW health posts. MIRA was started in India and is a mobile phone based health monitoring system. The system was designed to help pregnant women and their medical caregivers to better evaluate pregnancy progress and dispense health information. To start the program AIL had to buy the necessary equipment and phones and translate the manuals into Farsi, as well as preparing registration forms and data collection procedures.
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CHWs underwent training in the MIRA program. Some CHWs lacked the necessary literacy skills so AIL trained their daughters too so they could assist their mothers. The house numbering in the Afghan villages was not always clear, so AIL developed house ID systems to help with registering the family units.
CHWs have registered 2,695 families including 313 pregnant women and registered relevant child immunizations. All the data upon collection is transferred into computer files. CHWs visit the families each week collecting the relevant data. The goal of the program is to reduce the maternal/infant mortality rate. This is a crucial issue in empowering women in the country. |
Health Education
AIL has a multi-faceted health education program that uses multi-day workshops, mini workshops and integrates health messages into other activities such as patient care or general education classes. In its health care approach AIL always links health care and health education creating a more pervasive care and knowledge model. As patients wait to been seen by heath staff all attend health education sessions which can be about other topics than their particular health concern. .
More in-depth health education workshops are offered through the clinics. These can be in the form of multi-day workshops, seminars or mini workshops. Topics covered can include: reproductive health, 3 hour Expectant Mother Workshops (see below), school health sessions, bird flu, hygiene, cough and cold, vaccinations and many more subjects.
More in-depth health education workshops are offered through the clinics. These can be in the form of multi-day workshops, seminars or mini workshops. Topics covered can include: reproductive health, 3 hour Expectant Mother Workshops (see below), school health sessions, bird flu, hygiene, cough and cold, vaccinations and many more subjects.
AIL disseminates health education whenever and where ever possible and so health lessons are given by its teachers at Learning Centers and by teachers trained by AIL who are at schools, by Community Health Workers (CHWs) as they treat patients, by disaster relief aides as they give out supplies. A few words on good health habits can make a big difference. AIL is making the acquisition of health knowledge something routine in life. AIL was the first organization to teach about health at Learning Centers and in schools and began providing health training to teachers in public schools in cooperation with the Ministries of Health and Education in Herat.
When delivering health services AIL also models and teaches human rights, peace, democracy, and leadership. New skills and information mean Afghans are becoming healthier, empowered to take care of their health and all aspects of their lives and to advocate for themselves. All of this means they are more hopeful for the future. Together, Afghans are creating a healthier, democratic, rights-based and self reliant culture in Afghanistan.
When delivering health services AIL also models and teaches human rights, peace, democracy, and leadership. New skills and information mean Afghans are becoming healthier, empowered to take care of their health and all aspects of their lives and to advocate for themselves. All of this means they are more hopeful for the future. Together, Afghans are creating a healthier, democratic, rights-based and self reliant culture in Afghanistan.
Health Workshops
In depth health workshops are offered on hygiene, disease prevention and nutrition as well as reproductive health and first aid. Most participants have never attended any kind of workshop on health and are often poorly educated or illiterate. The stories they relate often tell of “old wives tales” for curing infection or treating wounds which prove not only ineffective but often make matters worse. The impact of even basic health education is best told through stories from past Health Workshop participants:
In depth health workshops are offered on hygiene, disease prevention and nutrition as well as reproductive health and first aid. Most participants have never attended any kind of workshop on health and are often poorly educated or illiterate. The stories they relate often tell of “old wives tales” for curing infection or treating wounds which prove not only ineffective but often make matters worse. The impact of even basic health education is best told through stories from past Health Workshop participants:
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Malali said:
“I am a teacher in a high school and I didn't have information about these health issues. AIL teaches us about reproductive health, especially for my village, as I know the women of Afghanistan need to learn about their health issues. I didn't know about pregnancy. I have one child and I didn't know how I should feed her which is very important to learn about. Fortunately, I learned all the issues at the workshop. The teacher says I asked many questions regarding the reproductive health issues and I got all the answers I needed.” |
Another participant said:
“AIL is like a key unlocking society's problems. Every time I come to the workshop I try to learn about the health of women and the health of society. Every day it opens the locked problems of the people in the society. Before I came to this workshop I didn't have any information about health issues and I didn't know how to prevent pregnancy. Now I do know how to prevent it. I should say that I have six children and all my children are small. I learned this is from my lack of knowledge and lack of education about nutrition. I will use this knowledge and tell others too”.
“AIL is like a key unlocking society's problems. Every time I come to the workshop I try to learn about the health of women and the health of society. Every day it opens the locked problems of the people in the society. Before I came to this workshop I didn't have any information about health issues and I didn't know how to prevent pregnancy. Now I do know how to prevent it. I should say that I have six children and all my children are small. I learned this is from my lack of knowledge and lack of education about nutrition. I will use this knowledge and tell others too”.
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Expectant Mother Workshops
Pregnant women are referred to a workshop by clinic staff or a Community Health Worker. The workshop takes less than 3 hours on one day and provides expectant mothers and their birth attendants with detailed health education relating to pregnancy, normal and complicated delivery, breastfeeding and high risk factors and signs of problems for mother or baby. The training is aimed at mothers who have limited access to deliver at clinics or hospitals. The goal is to reduce maternal and infant injuries and deaths during childbirth and the immediate aftermath through access to information on proper care and by encouraging birthing at a clinic or hospital if possible. Following the workshop, a basic delivery kit is given to each pregnant woman and a scarf to each caregiver. |
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The program has been running since 2011 and the vast majority of pregnant attendees (99%) have had their babies at a clinic or hospital. This is a remarkable result in a society where home birth is the norm and where today’s mothers were most likely born at home and have mothers themselves or mothers in law who believe home birth the accepted practice as they themselves experienced it. These women have little or no access to women who have had births at clinics or hospitals so they are stepping out of the known in choosing a clinic based birth.
