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The aim of BLiSS program is to reduce infant and maternal mortality and morbidity rates in Afghanistan by educating women, men, and their families, about pregnancy and birth and appropriate antenatal care, as well as linking communities with health care providers.

BLiSS main picture

The Challenge

Afghanistan has one of the highest fertility rates in the world; with 4.9 children per mother (WHO 2013). It is also ranked number 18 on the list of countries with the highest under 5 mortality rate; 99 deaths per 1000 births (UNICEF 2014). 65% of women in Afghanistan give birth in their homes and 70% of women do not receive any antenatal care or a visit from a trained health worker.

Our Response

Operation Mercy Afghanistan developed the Birth Life-Saving Skills (BLiSS) program in conjunction with "Community Development Consultants" in 2005. BLiSS is a health education program focusing on pregnancy, birth and new-born care. It includes 17 lessons designed to reach an illiterate audience with role plays, stories, picture cards, and models that help the participants to learn the material and make decisions based on that knowledge. Participants are encouraged to share knowledge gained with other members of their communities.

BLiSS teaches pregnant women, mothers, and the women who attend them during birth. The BLiSS material covers lessons on the leading causes of maternal and infant morbidity and mortality, healthy choices in pregnancy, warning signs during pregnancy and birth, and the immediate care of the new-born. They also practice basic First Aid for use until a referral to a healthcare professional can be reached.

Potential Long Term Impact

BLiSS teaches on the importance of accessing medical help in a timely manner and encourages women to speak about their birthing traditions and ideas, and to look carefully at their underpinning cultural beliefs. Through participatory learning and role play BLiSS addresses many of the cultural beliefs that are harmful, such as:

  • childbirth is dirty and shameful and should occur in the dirtiest room - usually the cowshed
  • colostrum (the milk produced in the first three days) is dirty and should not be given to babies
  • if a woman faints from lack of blood, she should be stood up and a gun fired next to her head

Most men in rural villages don't allow their wives to attend any hospital or clinic which is the cause of many deaths during pregnancy. BLiSS also holds training sessions for men, the primary decision makers in the home. With greater understanding of the needs of pregnant women and new-borns, male heads of households are more likely to make informed decisions that support the health of their family members.

After attending this training, one man insisted that he take his wife to the hospital in Mazar when he realized she was having serious problems during the pregnancy, despite his mother and others objecting.

The wider community will be better equipped to support mother's and babies at a critical time in the health and life of the individuals but also giving them all more opportunity to thrive.

Find out how RED International has linked BLiSS to the 1000 Days, Mother & Child Campaign.

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