In 2002, soon after the NATO-led overthrow of the Taliban
regime, a survey of maternal mortality in Afghanistan
was done, commissioned by the Afghan Ministry of
Public Health, the US Centers for Disease Control and
Prevention, and UNICEF. The results were published in
The Lancet in 2005 and estimated the maternal mortality
ratio (MMR) to be 1600 deaths per 100000 livebirths
(95% CI 1100–2000),1,2 among the highest in the world
and consistent with the UN estimates.1 In the most remote
rural district, Ragh, in mountainous Badakhshan Province,
the estimate was 6507 per 100000 livebirths,1
among the
highest MMRs recorded globally. There, the most common
cause of maternal deaths (30%) was obstructed labour
and most women who died were young.1
In the two most
remote rural sites, Maywand and Ragh, no woman who
died was assisted by a skilled birth attendant.1
The survey
provided a benchmark and pointer to a national priority.