Family Planning in IDP camps in Afghanistan

Project Lead(s): Andrew MacNab

Issue

Mother and child mortality rates in Afghan IDP camps are among the highest in the world. Many women and girls have unplanned pregnancies or are forced into child marriage.

In Afghan culture, decisions are made by men with few women possessing decision-making power when it comes to their health, family planning, and contraception use.

 Solution

 The intervention used male-dominated cultural elements in Afghan society and religious endorsement to promote knowledge about contraception among men.

 The project had different aims for men and women. For men, the project aimed to:

1. Increase men’s understanding of the methods and benefits of family planning, limiting family size, and longer birth spacing intervals.
2. Endorse that contraception is acceptable in Islam.
3. Enable husbands to have more, and better informed, spousal dialogue.

For women, the project aimed to:

1. Enable them to have spousal dialogue related to family planning and gain their spouse’s support for contraceptive use.
2. Facilitate access to midwives and traditional birth attendants (TBAs) for health information and advice.
3. Access family planning supplies.

It worked with an Afghan partner called Tabish to establish men’s groups where they could discuss and learn about the practical and financial benefits of contraception in a safe and culturally appropriate environment. Respected elders and Imams were trained to lead the groups and were part of the family planning information sharing process.In each of the 3 IDP camps 20 men’s group leaders and 20 TBAs were trained. Additionally, 4 midwives were hired.

Outcome 

The project studied 300 families in each camp and found that in the target communities men had changed their general attitude towards contraception and women reported spousal support and the ability to access family planning services.

664 men attended more than 5 men’s group sessions. Men who attended the groups reported acquiring new knowledge and changing their attitude towards family planning.

840 families not using family planning at baseline began using different family planning services. 94% of women not using contraception prior to the intervention began regular use, while women in the camps who were not in the intervention cohort also came forward to inquire about contraceptives and family planning services.

Interestingly, mothers-in-law were found to be a significant force in influencing male decision making around family planning.

One comment made by a woman during evaluation sums up the global impact in the camps: “the whole atmosphere in the camps towards Family Planning has changed – it is no longer a taboo subject.”