Afghan Women’s Health: The Ongoing Crisis

Updated: Dec 17, 2020

Women are the key to the future


It’s no cliche, its fact. Citing research from Georgetown University, peace talks for war/conflict resolutions are more effective when women are involved. According to the research, ”studies find that when civil society groups and women’s groups are included in negotiations, resulting peace agreements are 35 percent more likely to last at least 15 years. This holds true for more than just foreign policy.


According to a team of students from Kings College London, gender inequality poses a severe economic impact. Women are the key economic development in third-world countries. Based on their studies, countries are losing over $160 trillion in wealth due to the obstacles that bar women from entering the labor market.


It’s not hard to see, and the facts support the truth. Investing in women is crucial to our society. Not only for the sake of gender equality, and human rights, but for the fact that we can benefit heavily from egalitarian practices that will in turn advance our societies. In most of the third-world however, women face extreme socio-economic, religious, and cultural barriers that bar them from maximizing their true potential.


In Afghanistan alone, the health crisis poses the biggest marker of gender inequality for women in the country. Aside from the lack of representation in politics, labor market, and education, women lack the most basic forms of healthy living. The country has faced many challenges due to the decades of war, but women remain the primary subject affected due to conflict: socially, politically, and economically. Though the country has seen improvements in healthcare infrastructures, Afghanistan’s women face disparities in access to health education, and treatment, at alarming costs. These disparities have been exacerbated by the ongoing conflicts that continue to divide the country, and threaten progress.



Forgotten and Neglected: Afghan Women During the Taliban Regime


Afghan women suffered the most during the brief, yet destructive, rule of the Taliban regime from 1996-2001. The ”law and order” placed under this tyrannical group, was based on strict interpretations of Sharia-Law, a system based from various practice of Islam. Among the changes imposed by this ruling party, included extreme gender segregation, and gender inequality for women, reversing gender rights backwards for decades. Prohibited from leaving the house for most circumstances, except for when accompanied by a male family member, women were barred from jobs, education, and above all, healthcare.


By 2000, Afghanistan became among the worst countries in the world to be a child and a woman. Maternal mortality and child mortality rates stood at alarming rates that were unseen in most parts of the world. According to World Bank, the maternal mortality rate was 1600 of 100,000 births. Pertinent to women’s accessibility was the ability to be seen by female doctors. However, with the mass reduction of women in the workforce, many hospitals had to sizably reduce bed capacity for women. In Kabul alone, the city‘s inhabitants of over 500,000 women were left with only one low-funded clinic to access care in the year 2000.

By the end of the Taliban rule in 2001, the international community estimates the following data for the conditions of the country: under-five mortality rate was 257 out of 1000 children born, 25% of the country’s children faced severe malnutrition, and 92% of babies were delivered without trained personnel. Prenatal and neonatal was scarce during this time, and widely unavailable (Rakesh, Bauer, et. Al).


The Taliban’s strict rule left Afghan society in destitution, despite its toppling. As the country struggled to face insurgents, and instill a new government, the people struggled to resume to a normal way of life. Gender inequality and discrimination had made its mark, and in most of the country, women remained in unequal status roles to their male counterparts. Healthcare for women, accessibility to health education, and the reversal of social stigma surrounding women’s health, posed as a great challenge to the international organizations pouring funding and resources into the country to support the newly founded government’s efforts to modernize Afghanistan’s infrastructures.


Social Barriers to Health Accessibility: The Case of the Mahram

Despite the fall of the Taliban regime, and subsequent efforts to modernize the country, Afghan women face many social barriers and stigmas rooted in traditional practices based on Islamic Sharia-Law that prohibits them from acting on their health symptoms and seeking care, independently. Afghan women in rural regions are most affected by the gender inequalities that bar them from leaving their homes without the accompaniment of a Mahram. This social practice provides limitations for women who are already uncomfortable about seeking healthcare due to a lack of education and resources, and only is exacerbated by the patriarchal dynamic that makes these women dependent on men for their health.


An excerpt from Premiere Urgence Internationale:


“They call him the mahram. He is a man who is trusted within a family. He can be a father, a brother or a father-in-law. He accompanies one or more women in the family on every trip they make. Without the mahram, it is impossible for them to leave the village, and even to go to a health centre. These women’s schedules are intimately linked to his. ‘In the areas where we work, in Nangarhar and Kunar, women are not the only ones that decide if they want to go out,’ said Catherine Goudouneix, assistant to the Afghanistan mission leader.‘There are many challenges when it comes to access to healthcare for women in this country. We are developing specific projects so that they can be looked after by specialists, and so they do not have to stay at home with inadequate care.’In these Afghan provinces, if a woman goes to hospital, she will only be cared for by female staff. ‘Male doctors sometimes check female patients’ blood pressure, but nothing more.’”


Progress Through the Decades: A Glimpse of Hope for the Ongoing Crisis


Though the disparities in accessibility to healthcare has improved in the country, Afghanistan has a long road ahead in its battle to combat lacks in infrastructure, socioeconomic barriers, and social taboos, that affect its population’s most vulnerable: women and children.


Geographical location poses as another challenge for the accessibility to health facilities and resources. However, the country has seen increased initiatives that are focused on tackling on this added challenge. Implemented in 2015, the System Enhancement for Health Action in Transition (SEHAT) project was established with the aim of increasing the utilization and quality of health, nutrition and family planning services across the country.The projects provided support to rehabilitate Mirbachakot district’s health facilities, which had been underfunded, understaffed, and poorly resourced. A total of 42 rehabilitated BHC facilities provide BPHS, to the district’s 35,000 residents. Each station serves 100-150 families with services including vaccinations, maternal health care, and nutrition.


In partnership with Muslim Aid USA, the Bayat Foundation, a non profit organization founded and based in the country, has launched plans to build and supply Kabul's landmark hospital - a four-floor, 25,000 square foot Maternity and Neonatal Hospital currently under construction in Kabul City. has launched the Gul E Seb initiative to support the right for women’s health accessibility in Afghanistan. The hospital will be able to provide highly specific treatments that are currently unavailable from other hospitals and healthcare centers in Afghanistan. The maternal and neonatal hospital will provide the most advanced levels of Surgical, Maternal, Pediatric, and Cancer treatment available for women and children in Afghanistan.


Afghan Women’s Health Today


Statistical data has shown that efforts in the country are producing promising results to the ongoing crisis. Maternal mortality has dropped to: 327 deaths per 1000 births. Prenatal care has gone up to 39% in 2010, compared to 3% in 2003. Child under-5 mortality rate has gone down to 97 per 1000 live births. Current initiatives in the country aim to decrease these numbers substantially.

Afghanistan is still widely regarded as one of the most difficult countries in which to be a woman. Women and girls are vulnerable to discrimination, and attention to female adolescent health and protection of reproductive health is key. Much of maternal and childhood morbidity and mortality are concentrated in poor and remote populations and in areas where many mothers have no education.Basic health services remain out of reach for 23% of the population, and performance on health-care access and quality is extremely poor. This is a concern in an era of emerging health challenges and virus outbreaks.Efforts to modernize the healthcare system in the country continue to face many challenges.


Yet at the heart of these efforts, remains the most important key to progress: understanding the importance of women in society, and the determination to provide gender equality for all. As peace negotiations continue between the Afghan government and the Taliban, the country cannot forget its most crucial asset: the resilient women of the country, who’ve time and time again risen through incredible hardships to provide for families, and communities, and whose voices in health and wellness cannot be forgone for the sake of the future of Afghanistan.



“The hidden war against women is waged worldwide, but its effects are nowhere more apparent than in Afghanistan, where women’s health is closely linked to peace, sickness, and war, and where adequate health care, basic social services, social justice, and education are missing.” - Sima Samar




 

Sources:


World Bank:

https://www.worldbank.org/en/news/feature/2017/04/10/health-education-programs-empower-women-address-capacity-shortages-afghanistan


https://www.worldbank.org/en/results/2013/04/18/afghanistan-better-health-outcomes-women-children-poor


Rasekh Z, Bauer HM, Manos MM, Iacopino V. Women's Health and Human Rights in Afghanistan.JAMA.1998;280(5):449–455. doi:10.1001/jama.280.5.449


Premiere Urgence

https://www.premiere-urgence.org/en/women-s-health-in-afghanistan/




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