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Background Afghanistan has one of the world’s highest maternal mortality ratios, in some areas more than 60% of women have no access to a skilled birth attendant. The main challenges for Afghan childbearing women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, according to the national plan for midwifery education. The aim of this study is to explore women´s experiences with professional midwifery care in four villages in Afghanistan covered by the project, to uncover challenges and improve services in rural and conflict-affected areas of the country. Methods An explorative case study approach was adopted. Fourteen in-depth interviews and four focus group discussions were conducted. Totally, 39 women participated; 25 who had given birth during the last six months, 11 mothers-in-laws and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed through a thematic content analysis. Findings The women reported that the trained midwives’ life-saving competence, skills and care were important reasons for giving birth in a clinic, and the midwives seemed to be appreciated by many of the women, making more women to choose to give birth in the clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence from the midwives. Moreover, disapproval from relatives, shame and problems with transport and security were important obstacles to women giving birth in the clinics. Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilization and satisfaction with maternal and newborn health services in rural Afghanistan. Nevertheless, the quality of the services is still wanting, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritized.

The security of medical images becomes increasingly important for many reasons such as confidentiality, authentication, and integrity. In this context, the digital watermarking has appeared as a solution to protect the medical data diffused in hospital networks. In this article, we present a robust technique of medical image watermarking of various modalities such as Computed Tomography (CT Scanner), Magnetic Resonance Angiography (MRA), Magnetic Resonance Imaging (MRI), and X-Ray imaging, based on the combination of the Stationary Wavelet Transform (SWT) and the Fast Walsh-Hadamard Transform (FWHT). In our contribution, we have inserted the watermark of size 512 × 512 in the high-frequency subbands of the original image of the same size in order to increase the protection. The experimental results show that our contribution gives a good robustness against geometric and compression attacks compared to other techniques cited in the literature.

The security of medical data plays an important role in preserving their integrity and confidentiality. This paper presents a robust multiple watermarking algorithm based on a combination of discrete wavelet transform (DWT), discrete cosine transform (DCT) and singular value decomposition (SVD). In this proposed method, we have inserted three watermark images (a patient image, a doctor image and a fingerprint of the patient) into a single cover medical image. In the insertion phase, the original image is decomposed into the third level of DWT, and then the DCT and SVD transforms are applied on the selected sub bands (HH1, HH2, and HH3). The first watermark goes through the same steps that the original image. Moreover, the second and the third watermarks are decomposed until the second level and the first level by DWT respectively and subsequently transformed by SVD. The singular values of the three watermarks are inserted into the singular values of the original image. The experimental results show that the proposed method gives better performance in terms of capacity, quality and robustness against various attacks compared to other reported techniques.

In this article we present a novel method of extraction and combination descriptor to represent image. First we extract a descriptor shape (HOG) from entire image, and in second we applied method of segmentation and then we extract the color and texture descriptor from each segment in order to have a local and global aspect for each image. These characteristics will be concatenate, stored and compared to those of the image query using the Euclidean distance. The performance of this system is evaluated with a precision factor. The results experimental show a good performance.