Ram Bibi is 30 years old and pregnant with her sixth child — but this time feels different. In Helmand province in southern Afghanistan, she walks to the Qari Safed family health house near her home, where midwife Marzia screens her for anemia, gives her supplements and vaccinations, and teaches her to spot the danger signs of pregnancy. When her time comes, Bibi plans to deliver her baby right there, with skilled help close by. Her previous five children were all born at home without trained assistance, and both she and her newborns suffered infections.
In another remote village in northwestern Afghanistan, 40-year-old Manawara began bleeding in her 38th week of pregnancy. She reached her local family health house in time. A midwife found her baby was in breech position, and medication plus emergency protocols stabilized her until she delivered a healthy child.
This kind of care might not sound remarkable — but in Afghanistan, one of the most dangerous places on Earth to be a mother, it is life-changing. In 2024, a study found that fewer than one-third of Afghans could access health care at all, weighed down by a crumbling public health system and severe limits on women's movement.
The lifeline is the family health house, known in the local Dari language as Ashiana-e-Sehi. Since a program started by the United Nations Population Fund (UNFPA) in 2009, more than 450 of these friendly community clinics have become crucial access points for maternal and newborn care. Most sit in "white areas" — places at least 10 kilometers, or a three-hour walk, from the nearest basic health facility. Each house is built on community-owned land, serves about 1,500 to 4,000 people, and is run by a trained midwife recruited from the local population. UNFPA supplies basic equipment and 35 medical and non-medical items needed for maternal care.
The clinics are often a village's only health facility. At the Arkalik FHH in northern Afghanistan's Farhan province, an hour's drive from the nearest hospital, midwife Laila Amini sees up to 70 patients a day — far more than the 300 a month it was built for. "Several years ago, a young girl died of pregnancy-related complications because her family couldn't get her to the hospital in time," she says. "Since then, I have been monitoring the health of all the women and children." She says proudly that her community has not seen a single pregnancy-related death in seven years.
An assessment by the International Planned Parenthood Federation found that nearly three-quarters of surveyed women lived within one kilometer of their local FHH, and 82 percent could walk to it. A striking 88.7 percent rated these clinics as "very important." Around the world, community medicine is closing the gap — Bangladesh runs over 13,000 community clinics, and maternity waiting homes in Malawi, Zambia and Kenya help remote mothers stay near hospitals. Thanks to people like Marzia, Amini and Monika Rahmati, Afghan mothers are no longer alone when they need help most.