Submission ID 118557
| Issue/Objective | Since 2011, the Afghan Midwives Association (AMA), a midwifery-led national NGO, has led a countrywide mentorship initiative to strengthen midwifery practice and improve maternal and newborn care. With donor support, the program has expanded from three to 18 provinces, reaching at least 10 remote health facilities per province each year. It targets newly graduated or unsupported midwives working in underserved areas, where lack of supervision, mentorship, and equipment often leads to a loss of clinical confidence, especially in managing complications. AMA's model pairs experienced midwives with early-career mentees to provide in-person and remote coaching in technical, ethical, and systemic aspects of care. Mentors are trained in high-impact interventions (HIIs), family planning, maternal and newborn health, and post-abortion care. The goal is to help mentees deliver respectful, competent, and confident care aligned with their national scope of practice. |
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| Methodology/Approach | Mentors conducted three one-week visits to remote facilities, using OSCE checklists to coach midwives in six focus areas: ANC, PNC, normal delivery, family planning, complication management, and health system support. Mentorship included hands-on training, facility assessments, and follow-up with stakeholders. AMA implemented baseline and endline evaluations, remote supervision, and coordinated with government and partners to ensure quality and accountability. |
| Results | Baseline assessments showed significant gaps: only 17% of mentees demonstrated competency in managing complications, and 29% in ANC/PNC. Eighty percent had never discussed birth planning, and just 20% provided maternal mental health counseling. The program's competency-based model, emphasizing knowledge, skills, and attitudes, required all mentees to pass a 100% skills exam using patients or simulations. By endline, 100% of mentees passed in all key areas, demonstrating major improvements in clinical ability, communication, and confidence |
| Discussion/Conclusion | This mentorship model not only addresses clinical gaps but also fosters leadership and self-efficacy among young female midwives. By linking frontline capacity-building with systemic advocacy, AMA's approach advances equitable maternal health services. It offers a replicable model for fragile and resource-limited settings, contributing directly to the global health agenda of youth empowerment, gender equity, and inclusive health leadership. |
| Presenters and affiliations | Bibi Zahra Mirzaei Afghan Midwives Association Gette Saduzai Afghan Midwives Association Sediqa Attaei Afghan Midwives Association Fahima Naziri Afghan Midwives Association Bibi Zahra Mirzaei Jhpiego an afflation of Johns Hopkins University |
