One of the most impoverished countries in the world, Afghanistan has literally been devastated by decades of conflict. The public health sector has also been hard hit by the debilitating war, with many citizens having little or no access to healthcare, particularly in remote rural remote areas.

Unfortunately, disparities persist in provision of health services to men and women. Women cannot access medical services because they are not allowed to visit health facilities without male companions or to be examined by male medics. The number of female healthcare providers is very low, more so in the countryside, where more than 50 percent of the population lives.

Even though there have been efforts by the Ministry of Public Health and the international community to jack up the number of midwives and trained female healthcare staff. Cultural barriers and in some cases insecurity, however, militate against the success of these endeavors. As a consequence, many women lose their lives in the gestation period.  

“Women of reproductive age are particularly vulnerable in a country still having an unacceptably high maternal mortality rate. Only 50 percent of deliveries take place in health facilities, where post-natal care can be provided by trained health staff,” the United Nations Office for Humanitarian Coordination said in the Humanitarian Needs Overview for 2018.

Maternal mortality ratio was 396 per 100,000 live births in 2015, report WHO, UNICEF, UNFPA, World Health Survey for 2016 said over 23 percent of deaths among women aged 15-49 are linked to maternal causes — the highest among all other causes in this age group in the country.

One of the several maternal death causes is male family members’ refusal to let women visit a male physician in health facilities. Additionally, many women resort to harmful traditional practices to avoid visiting male doctors. No credible data is available on the women’s deaths resulting from inadequate access to healthcare.

Harmful practices include barring mothers from bathing and breastfeed babies in the first three days after delivery, a resort to self-medication, home remedies and faith healing. In some cases, formal health services are perceived as shameful by a woman, her husband or older family members because it demonstrates publicly the need for help during a vulnerable period, according to a qualitative assessment by William Newbrander and Team (2014).  

In many instances, women do not have access to health services because there are no male family members to take them to health facilities. Also, some husbands do not allow their wives to visit health clinics or hospitals.  

In Afghanistan, women have been faced with injustices and a brazen denial of rights in terms of health services. In large measure, it is a question of gender inequality. The Ministry of Public Health and other agencies can address this issue through comprehensive long- and short-term approaches. Training community health workers and offering incentives to female health workers working in remote areas of the country will help resolve the problem in the short term.

However, there is need for long-term and more effective measures to address the problem. The Ministry of Public Health, through the Health Promotion Department, should conduct community outreach programmes that give women access to health services during the gestation period. It is necessary for the health of mother and child.

Community outreach should also involve religious leaders, who are highly influential among members of the general public. Additionally, greater attention has to be paid to girls’ education  to increase the number of educated women over the longer haul and recruit medics from within the community.

Women’s health is the backbone of healthy society. Vulnerable women should be afforded the opportunity to get health services even if they need to visit a male health practitioner. A comprehensive health promotion plan, involving all stakeholders and communities, could play an effective role in improving Afghan women’s overall health situation.

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