Lessons from the field: Using a women's empowerment model to train midwives and doctors in Afghanistan

Afghan women are among the world's most disempowered due to multiple gender-based restrictions, and decades of war and oppression. Many Afghan health providers have never received basic training in contraception and STIs. To raise their knowledge/clinical skills, we determined that their training should employ a women's empowerment model of teaching. In 2006, we trained 47 female midwives/doctors in four clinics in Kabul and Mazar using women's empowerment strategies. Our objectives were to improve knowledge/clinical skills in family planning (particularly IUD insertion), to reduce infections, to enhance detection/treatment of STIs and their approach in educating client in STIs/HIV prevention. Our empowerment strategies included: (1) role modeling by using professional Muslim women trainers from neighboring Iran, who had overcome similar constraints; (2) developing critical thinking skills by focusing on the status of Afghan women and comparing them with other women in the region; (3) encouraging individual consultations between trainers and trainees to identify and overcome hurdles in completing the program, such as obtaining husbands' permission; (4) fostering teamwork and personal responsibility by involving trainees in solving daily problems during the program; and (5) overcoming fatalism by promoting women as agents of change and a culture of “it can be done.” The program was evaluated using a pretest/posttest of trainees' knowledge and a clinical skills test. A significant increase in trainee knowledge (from 53 to 89%) and average score of 86% in clinical skills test was achieved. In this presentation, we will discuss the empowerment strategies used, lessons learned and our 2007 activities.