From taking lives to saving lives: Training male health providers in post-conflict Afghanistan

A common challenge in post-conflict environments is to re-establish health services. Trained and capable local health providers are an essential part of this process. Many health providers in war-torn Afghanistan have experienced forced migration or refugee status, lost family members, or acted as fighters/defenders of their communities. Feelings of hopelessness and mistrust among Afghan providers, coupled with their own trauma, often impede learning. It is important that programs approach providers' needs comprehensively to build the trust and motivation necessary for a program's success.

We have developed an innovative model for training of health professionals in Afghanistan. Our strategies were designed to create hope and to inculcate understanding that the bulk of re-building of Afghanistan lies on the shoulders of Afghans, not international entities. This realization leads to accountability and reduces self-survival attitudes and the “hand-out culture” shaped by the enormous international assistance.

Our main techniques were: (1) Trainee-Centered Learning which respects trainees' past to establish solidarity and highlights trainees' strengths to raise self-confidence; (2) Positive Psychology which focuses on what works and is forward-looking, while also addressing male patriarchy and discussing everyone's potential in reconstruction efforts.

In 2007-2008, we trained 148 male doctors/nurses from 8 provinces in family planning/reproductive health. In the two months after the training, they actively promoted birth spacing and contraceptive use among their male patients and educated 10,420 men in rural areas.

Incorporating strategies that foster communication and understanding is crucial to create motivation and commitment by providers to participate actively and serve their post-conflict communities.