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Partnering for Sustainability
  A nurse performs an antenatal examination on a woman in Malawi. PHOTO CREDIT: PAUL JEFFREY
of successful change.
The MNCH project, supported
by PWS&D and the Government of Canada, wrapped up earlier this year, with approximately 175,000 people benefiting from the project in both Malawi and Afghanistan.
Working with locally based part- ners, the project enhanced the qual- ity and supply of health services by improving the skills of health care workers and building and renovat- ing health facilities. It encouraged the demand for health services and empowered women and adolescent girls to make decisions about their own health and that of their children, contributing to a reduction in mater- nal mortality rates. In Afghanistan, maternal mortality declined by 96% and by 75% in Malawi, in the areas where PWS&D worked.
People who participated in the project demonstrated strong knowl- edge of the importance of maternal health checkups, including ante and postnatal care, and hospital delivery, leading to lower maternal and infant mortality. Education and awareness on gender equality and sexual repro- ductive health helped reshape men’s attitudes, allowing more women the space to advocate for their own health. Increased access to family planning services and information has given women more control over when they have children, alleviating some of the burdens of having chil- dren too close together.
In Afghanistan, the project was implemented in four districts in Lagh- man province, where people had lim- ited, difficult or no access to health care services due to more than three decades of war, insurgent activity, political instability and insufficient
A woman is screened for malnutrition at a PWS&D-established health facility in Af- ghanistan. PHOTO CREDIT: CWSA
By Kristen Winters,
PWS&D Program Coordinator
My first visit to Malawi was in 2018 to visit PWS&D’s Maternal, Newborn and Child Health (MNCH) program. I was struck by the large number of groups involved in the project at the local level, from traditional lead-
ers to community health workers to teen clubs and peer educators—all working to improve the health of their communities. During a monitor- ing visit two years later, the change was evident—women and girls were more outspoken, there was increased knowledge of maternal, newborn and child health issues, and many stories
health infrastructure.
To address this need, six health
facilities were built to carry out ma- ternal, newborn and child health ser- vices and provide education. After a successful handover at the end of the project, these health facilities are now a permanent part of the health system of the Ministry of Public Health of Afghanistan, ensuring the sustainability of health services into the future.
The knowledge and skills women gained through the project will live on and continue to spread. Community leaders and volunteers will continue to share messages on safe mother- hood and provide a link for young women to health facilities.
Nazia is a mother of three children in Afghanistan, who now shares her positive experiences with the project with other women. She delivered two of her three children in facilities built through the project. “The postnatal services taught me to improve my diet
and to vaccinate my newborn,” said Nazia. “I advise the women in my vil- lage to go to the health facility for ante and postnatal care as it is good for both the mother and the child.”
Ultimately, the strength of the MNCH project lies in local involve- ment—communities working togeth- er to create positive change. In both Malawi and Afghanistan, community- based volunteers and health workers along with local government were actively involved, from project design to completion, which created real ownership over the project.
Through training, meetings and discussions, community members have been empowered to take active roles in promoting safe motherhood and linking others to the services available. Even though our role in the project has wrapped up, community ownership ensures that the success- es achieved in maternal, newborn and child health will continue far into the future.
 Since the project began in 2016:
• The number of women successfully delivering at a health facility with a skilled birth attendant increased from 17% to 50% in Afghanistan.
• In Malawi, routine vaccination rates for children under five rose from 69% to 84%.
• In Afghanistan, 64 nurses, midwives and community health workers received comprehensive health care training, with specific emphasis on maternal health services.
• The proportion of women who adopted appropriate feeding practices, including exclusive breastfeeding, increased from 47% to 89% in Malawi.
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