A passion for health, nutrition and her community

Bringing babies into the world, and keeping them healthy as they grow up is all in a day’s work for 24-year-old midwife, Fatima.

By Abdul Basir Rahimi
A patient visiting Bibi Fatima in Panjshir hospital for checkup
UNICEF Afghanistan/2018/Mehrdil

05 November 2018

Panjshir, Afghanistan, 5 November 2018 - Having passed her two-year community midwifery course with flying colours, Fatima now works at the Abdara basic health centre in Annaba district, northern Panjshir province.

Fatima is passionate about health care and caring for her community. Before becoming a midwife, she worked as a vaccinator in Shaba basic health centre, Panjshir province, for three years. Her passion for the profession of medicine and the health and nutrition of the Panjshir people prompted her to study midwifery, and turned her into the successful midwife she is today.

Fatima works on maternal and child health, nutrition and the infant and young children feeding (IYCF) programme. She provides antenatal care, post natal care, family planning and, most importantly, delivery services daily to the most vulnerable people in the village.

Fatima gives IYCF counselling to every pregnant and lactating woman she visits, and is also responsible for the outpatient treatment programme for children with severe acute malnutrition (OPD SAM). She serves every child aged 6–59 months who is diagnosed with SAM.

Fatima uses the mid-upper arm circumference (MUAC), oedema and weight/height criteria and assesses children for medical complications and appetite. When children are admitted to the OPD SAM programme, they receive weekly ready-to-use therapeutic food and attend the health facility every week until they recover.  

Fatima in Panjshir hospital
UNICEF Afghanistan/2018/Mehrdil

The integrated SMART nutrition survey, conducted in 2016 in eight districts of Panjshir province, revealed that: global acute malnutrition prevalence based on weight for height, MUAC and / or the presence of bilateral oedema was 17.7 per cent; severe acute malnutrition was 5.5 per cent; the prevalence of stunting in children under 5 years was 35.5 per cent; 23.8 per cent of women of childbearing age were malnourished; and the MUAC cut off was below 23 cm.

The survey revealed the need for an OPD SAM programme for 5.5 per cent of SAM children, and IYCF counselling for 35.5 per cent of stunted children. This chronic malnutrition can only be prevented by improving maternal and child nutrition, which is mainly done through IYCF counselling. Counselling ensures acceptable nutrition during pregnancy and lactation for mothers, and acceptable nutrition for children from birth to 23 months.

Each month the Abdara basic health centre aims to treat 18 children for SAM. During the last quarter, 54 SAM cases were admitted to the programme, and thanks to Fatima’s determination and the cooperation of the health facility’s community health supervisor, 87 per cent of these cases were cured. This is far above the Ministry of Public Health standard of 75 per cent.

During the last quarter, 166 pregnant and lactating women were counselled on maternal nutrition, exclusive breastfeeding, complementary feeding, breastfeeding positioning and attachment, and other key aspects of maternal and child nutrition. This will clearly impact on the prevention of malnutrition in mothers and children.

Thanks to the excellent work Fatima is doing in nutrition, she has earned the trust of the community. All babies in the health facility coverage area are born at the health facility, and mothers are coming for other maternal and child health services, including antenatal and post natal care, and family planning.

The local community has arranged transport for Fatima so she can visit the health facilities and the communities. Fatima’s day begins very early, but this doesn’t dampen her enthusiasm.

Fatima in Panjshir hospital
UNICEF Afghanistan/2018/Mehrdil

“Every day I get up at 5:30am,” she said. “After about three hours travelling I reach the health facility.

“But I never feel tired, as I see the happiness of the community and I’m being a supporter to the mothers and children who need my help. This gives me energy and motivation to cope with any kind of difficulties on my way to work.”