Health response to support access to safe reproductive and maternal health care for vulnerable women in Helmand province The proposed action aims at implementing a health response to support access to safe reproductive and maternal health care for vulnerable women in Helmand province (Nahr-e-Sarai, Nad-e-Ali and Nawa-e-Barakzaiy districts).  The project is designed to complement the Basic Package of Health Services (BPHS) system by tackling many of the barriers that prevent women from accessing existing services provided by the BPHS implementing partner, such as low awareness and acceptance of reproductive health, limited access to transportation and lack of screening at critical moments. 

Helmand Province is, according to the Humanitarian Needs Overview and Humanitarian Response Plan, but also the Health Cluster, an area classified as “extreme” in terms of severity of needs. In the 2018 Afghanistan Health Survey (AHS), it was found that Helmand province had the lowest proportion of households able to access health care within 2 hours, with over 30% reporting that travel times ranged from two hours to half a day.  Only 8% of women were estimated to be protected against Tetanus in their last pregnancy, rate much lower than the national average of 39.6%. At the national level, women and girls particularly face additional challenges in accessing healthcare. The combination of restrictions on men providing medical treatment to women and a shortage of women health professionals (particularly in rural areas), compromises the access for women to sustained and quality healthcare..

To address these needs, the project focuses on two core activities: 
1.	Developing “Community Awareness Teams” to carry out community mobilization to encourage women to access key reproductive and maternal health services.   Their activities will involve: 
a.	Working closely with Community Health Workers (CHWs) and Family Health Action Groups (FHAGs) to screen Pregnant and Lactating Women (PLWs) for acute malnutrition and identify women in need of reproductive and maternal health care
b.	Referring identified women to relevant health facilities for Antenatal Care (ANC), Postnatal Care (PNC) and safe institutionalized delivery, including providing cash reimbursements for referrals to Health Facilities (HFs) at critical moments (ANC, PNC, delivery)
c.	Referring identified PLW suffering from acute malnutrition to available and accessible nutrition program
d.	Promoting awareness of Infant and Young Children Feeding (IYCF), breastfeeding, care practices and hygiene 
e.	Screening women for psychosocial issues and providing Psychosocial Support (PSS) counselling identifying women at risk or affected by Gender Based Violence (GBV) and providing referral for multi-disciplinary support  
f.	Mobilizing community members for GBV through community dialogues 
2.	Providing capacity building to the BPHS IP (the NGO BRAC) in Helmand province to ensure quality service provision through specific training sessions, as well as providing HFs with key items such as hygiene kits kits to provide to patients following delivery.  

The expected impact of this intervention is to support vulnerable women to access to safe reproductive and maternal health care.

This project will be implemented during 12 months, from the 1st of April 2020 until the 31st of March 2021.