Maternal Health in Afghanistan
1
Maternal Health in Afghanistan
Introduction
Six years ago, the reality of Afghanistan’s maternal mortality rate (MMR) sent shockwaves through the international health community, and resolving the issue became a key priority in the interim government’s strategy. The poor state of maternal health in Afghanistan is due to a range of medical factors as well as social, political, economic and environmental determinants. To address the situation, Afghanistan’s Ministry of Health (MoH) introduced a nation-wide health service-focused package to help improve the health of the population. This essay will explore three key aspects of the government’s basic package of health services (BPHS) strategy: health service delivery, skilled birth attendants and community participation. These will be looked at through the lens of both the comprehensive and selective models of health care, and will determine which models have been utilized in the development of the BPHS. Current health situation When the Taliban’s rule ended in 2002, it left a country devastated by more than two decades of war. The health care system was nonexistent and today the maternal health situation remains poor. In 2002, Bartlett et al (2002) reported that in Afghanistan there are 1,600 maternal deaths per 100,000 live births, giving rise to one of the worst MMRs, an indicator of overall maternal health, in the world. This risk increases for women in rural areas with Bartlett et al (2002) reporting 6,500 deaths per 100,000 births in the rural province of Badakhshan. Factors influencing the poor health status of women There are numerous medical factors that can be attributed to the appalling state of maternal health in Afghanistan. Current research shows that 90% of births take place in the woman’s home rather than a health care centre and, furthermore, skilled birth attendants are present at only 20% of births (United Nations Development Plan 2008). This is primarily due to a lack of skilled female
Maternal Health in Afghanistan
Introduction
Six years ago, the reality of Afghanistan’s maternal mortality rate (MMR) sent shockwaves through the international health community, and resolving the issue became a key priority in the interim government’s strategy. The poor state of maternal health in Afghanistan is due to a range of medical factors as well as social, political, economic and environmental determinants. To address the situation, Afghanistan’s Ministry of Health (MoH) introduced a nation-wide health service-focused package to help improve the health of the population. This essay will explore three key aspects of the government’s basic package of health services (BPHS) strategy: health service delivery, skilled birth attendants and community participation. These will be looked at through the lens of both the comprehensive and selective models of health care, and will determine which models have been utilized in the development of the BPHS. Current health situation When the Taliban’s rule ended in 2002, it left a country devastated by more than two decades of war. The health care system was nonexistent and today the maternal health situation remains poor. In 2002, Bartlett et al (2002) reported that in Afghanistan there are 1,600 maternal deaths per 100,000 live births, giving rise to one of the worst MMRs, an indicator of overall maternal health, in the world. This risk increases for women in rural areas with Bartlett et al (2002) reporting 6,500 deaths per 100,000 births in the rural province of Badakhshan. Factors influencing the poor health status of women There are numerous medical factors that can be attributed to the appalling state of maternal health in Afghanistan. Current research shows that 90% of births take place in the woman’s home rather than a health care centre and, furthermore, skilled birth attendants are present at only 20% of births (United Nations Development Plan 2008). This is primarily due to a lack of skilled female