Afghanistan has the one of the highest fertility rates in the world with 6.6 children per mother (UNICEF, 2008) while at the same time the second highest maternal and infant mortality rates in the world: on average, in their first year, 153/1,000 children die (CIA Fact Book, 2010).

More than 25% of Afghan children do not reach their fifth birthday and over 85 percent of all the women in Afghanistan are delivering in their homes.  Only 16 percent of women have one or more antenatal visits from a trained health care attendant and during their lifetime, they have a one in eight chance of dying during pregnancy (UNICEF, 2008).

In conjunction with Community Development Consultants (CDC), Operation Mercy Afghanistan developed the Birth Life Saving Skills (BLiSS) program in 2005 to address this need.  BLiSS is a health education program about pregnancy, birth and newborn care. BLiSS trainers facilitate learner-centred, participatory lessons that guide illiterate women in the community through the process of recognizing maternal-child health issues, identifying health related problems and coming to a consensual decision about appropriate solutions.

Today, Operation Mercy continues to train Afghan midwives, nurses and health educators in teaching good  values, community development concepts and technical skills, with the aim of imparting increasing responsibility to Afghans.

In 2010 in Kabul and Mazar-e Sharif combined, we were able to train over 1200 women and 300 men in the BLiSS approach. Now there is a growing interest among the men to understand more about pregnancy related problems in their families as well as family planning. Women are very interested in motivating their husbands to participate in the training as the husbands are the decision makers when it comes to taking actions with complications during pregnancy and birth.

This has become such a successful and valuable program. There are many examples where this training has provided relevant and practical birth life saving skills.