Where are the men

In 2001, international forces invaded Afghanistan to topple the Taliban regime. International community has provided substantial financial support and professional expertise to re-build this war-torn country. The development has mostly occurred in major cities. Despite improvements in some areas, immunization and child mortality, Afghanistan still has world's second highest maternal mortality rate. Majority of the population lives in rural areas where maternal death remains the highest. A major factor in maternal death is the high fertility rate. On average, an Afghan woman bears six children during her reproductive years. Expansion of family planning has been excruciatingly slow. Contraceptive use is only 19%. Afghan women are unable to use family planning due to: shortage of health facilities/trained personnel, lack of adequate roads, restrictions, taboos. Afghanistan is a strongly male-dominated society. Many women cannot leave the house without a man's permission and need husband's permission to use contraceptives. Mobilizing men is a vital step towards reducing maternal mortality. In 2007, Family Health Alliance (FHA) began targeting and training Afghan male doctors and nurses in family planning/ reproductive health. Over 150 male doctors/nurses were trained in: contraceptive methods, STIs, violence against women. In two months, the trained health professionals counseled more than 15,000 men in family planning in rural areas. Afghan men should be viewed not as barriers to women's health, but as contributors and as an available local asset. In addition to numerous obstacles women face, the breakdown in security has become a major problem in women's access to health. Many do not visit clinics due to ongoing armed conflict in parts of the country and constant threat of suicide bombings. Progress and development in Afghanistan is unlikely without active participation of women in the society. This is only possible in an environment conducive to their health and well being.