“Shortages of equipment, supplies and medicine, a lack of fuel and heating facilities, especially now with winter approaching, and uncertain support from partners are just some of the challenges we’re facing,” said Shahla Oruzgani, head midwife at the maternity hospital.

At the Ahmad Shah Baba Hospital, where Dr. Aqila Bahrami works, the outlook is no less bleak. “We used to receive regular support from an international NGO, but their staff left in the aftermath of the events in August. Now we are in serious need of medical supplies,” she told the UN reproductive and sexual health agency, UNFPA.

Emergency kits

These two hospitals were among the first in Afghanistan to receive emergency reproductive health kits from UNFPA.

They contain essential drugs, medicine and equipment to ensure safe deliveries and support the reproductive, maternal and newborn health needs of at least 328,000 people.

More than 300 kits are being provided to hospitals and through mobile health teams, both in Kabul and across 15 provinces, with additional distributions planned for the coming weeks.

Soaring needs, waning resources

Since Kabul fell to the Taliban in August, more and more women have been seeking maternal healthcare from the Malalai hospital, many of them internally displaced from the northern provinces of Afghanistan into the capital.

Although the number of patients has gradually returned to normal as the displaced moved elsewhere, the hospital’s supplies have been left badly depleted.

Ms. Oruzgani fears the situation could get far worse should the healthcare system fail completely. Preliminary estimates warn that the current humanitarian emergency and suspension of lifesaving reproductive services for women and girls could cause up to 58,000 additional maternal deaths, 5.1 million unintended pregnancies and a near doubling of the unmet need for family planning over the next four years.

In a country where a woman dies every two hours from pregnancy-related complications, Ms. Oruzgani said: “The kits are critical at this time, as hospital resources are running out and the support we were receiving has dwindled. We can’t be sure where our next assistance will come from.”

Staying and delivering

Investments in public health have made great strides towards improving essential care in Afghanistan over the past 20 years, and the maternal mortality ratio has more than halved from 1,450 deaths per 100,000 live births in 2000, to 638 per 100,000, in 2019.

Yet this remains one of the highest rates in the world, and unless the current crisis is immediately addressed the health system could buckle. This would undo decades of progress on maternal health care and carry grave consequences for the lives of more than 4 million women and adolescent girls of childbearing age.

Despite escalating insecurity and hostilities, UNFPA and partners continue to operate and in October reached over 97,000 people with life-saving sexual and reproductive health and protection services, including prenatal care, safe delivery, antenatal care and family planning.