Raha*, a young mother in Afghanistan, was feeling desperate. The last year has been hard; she has struggled to find enough food for her four children. In Afghanistan, over the past year, food prices have soared, hundreds of thousands of people have lost work, and money has become scarce.
“Mothers and children are in a bad situation nowadays,” says Marzia Mohammadi, the founder and director of the Afghan Social Organization for Women, a local humanitarian aid organization and FHI 360 partner. “They need money to buy food, to feed their children. But the economic situation for the family is not good.”
Raha came to Mohammadi and shared her story. Her husband lost his job as a driver and to feed their family, they were considering giving up their baby boy — a devastating situation that has confronted many other parents as they scramble to find enough food to keep their families alive. (In March 2022, United Nations Secretary-General António Guterres noted that people in Afghanistan are “selling their children and their body parts” to provide for their families.)
“It was the hardest thing I have ever seen,” says Mohammadi, who was able to help Raha improve her family’s circumstances. Mohammadi found work for both Raha and her husband, and her organization pays their rent and makes sure that they receive humanitarian assistance each month. Raha’s son is now a year-and-a-half old and doing well.
Unfortunately, Raha’s family’s situation is not unique.
Nearly 19 million people — about half the country’s population — are facing “acute food insecurity,” defined as when a person’s inability to consume adequate food puts their life or livelihood in immediate danger. Of this total, nearly 10 million are children. The United Nations Children’s Fund (UNICEF) estimates that, in 2022, more than 1 million Afghan children under the age of 5 will likely become severely malnourished.
Because FHI 360 has experience in responding to crises and a history of working in Afghanistan, including a committed team led by Afghans, “we knew we were well-positioned to do something,” says Najibullah Siawash, FHI 360’s country representative for Afghanistan. “Now, more than ever, mothers with infants and young children need to be supported to breastfeed their infants and provide a diet that meets their nutritional needs.”
Afghan organizations lead in confronting the crisis
Since May 2022, FHI 360 has partnered with Just for Afghan Capacity and Knowledge and Care of Afghan Families to train front-line health and humanitarian workers to deliver emergency nutrition services to pregnant and lactating women and their infants — an effort that will make a difference for families like Raha’s.
“Maternal nutrition, breastfeeding and complementary feeding in infants and young children are critical for the survival and the well-being of women and children,” says Alessandro Iellamo, FHI 360 technical advisor for emergency nutrition. “In Afghanistan today, they are at dangerously low levels — and this is a key driver for the rapid increase in malnutrition among women and children.”
Pregnant and lactating women have greater nutritional needs — and the babies of malnourished women face risks that include premature birth, low birthweight and developmental delays.
FHI 360’s goal is to provide local partners the skills and tools they need to support women and children. “Navigating Afghanistan today takes a lot of understanding — now, even more than before,” says Iellamo. With this project, “we didn’t jump in with something designed for another context. We started by asking our partners, ‘What will make sense today in Afghanistan?’”
Through consultation with our Afghan partners, we agreed that the greatest need was to work with them to offer nutrition-related skills training, with a focus on protecting, promoting and supporting breastfeeding and providing safe and appropriate diets for women and children.
So FHI 360 and our partners mobilized staff from other NGOs, as well as front-line workers, health and nutrition managers and community health workers from 20 health facilities in two provinces: Kabul and Logar. So far, the organizations have trained more than 100 people in five workshops, with more workshops scheduled.
‘Imagine you are nine months pregnant’
The process of designing the workshops was iterative and collaborative. Our partners described the types of cases they were facing and what training their team members required to meet the emerging needs.
Sessions cover a range of topics. Some focus on protecting and supporting both breastfeeding and “complementary feeding” (the food babies need to meet their nutritional needs, in addition to what they receive from breastfeeding). Other sessions explore improving the quality of acute malnutrition treatment services for women and children, both within and outside of health facilities.
These participatory sessions are based on a comprehensive needs assessment. In one exercise, the facilitator asks participants to consider a situation: “Imagine you are nine months pregnant. What would your worries be for the future?” Then the facilitator asks the group why support for breastfeeding is important. Participants write their answers on cards, then pair up to share their ideas and rank their partners’ ideas. At the end, the group discusses the highest-scoring ideas.
Participants also develop plans to incorporate what they learned — such as complying with protocols and meeting standards — into their own health facilities.
Women creating positive change
About half of the participants in the sessions have been women. One of them was Mohammadi.
“The workshop contained important information that a mother should know,” she says. Participants were encouraged to share what they learned, which Mohammadi did with her staff (she employs 40 women and 16 men in Kabul and Bamyan provinces).
Another participant was Sediqa Tariq, a nurse working as a community health worker trainer with Just for Afghan Capacity and Knowledge. “We clearly see positive change in our day-to-day work” after working with FHI 360, she says. “I am pleased that I can help the mothers, who are facing many problems, and their children, who are suffering from malnutrition. Positive changes have been brought into their lives; they are hopeful for the future now.”
Mohammadi plans to continue sharing the information she learned in the workshop. “Everything that I can do for women, small things or big things — that makes me so happy and so proud.”
*Name has been changed. All illustrations by TM Design, Inc.