Reporductive Health - Ministry of Public Health Afghanistan

Reporductive Health

Afghanistan has made significant progress in rebuilding its health system, despite years of continuous conflict. This evident by the fact that in 2008, the proportion of population within one hour’s walking distance from a public health facility nationally was 57.4( NRVA 2007). The 2006 Health Survey found that the number of female staff has increased. The number of graduated midwives has increased to 1961 in 2009 compared to 467 midwives in 2003. There has been a gradual increase in the births attended by skilled birth attendants (SBAs). The Afghanistan house hold survey showed that 19 percent of births are attended by SBAs while NRVA, 2007 shows that the overall proportion of women delivering with a skilled birth attendant is 24 percent. Assessment of health services using the balanced score card (BSC) approach in 2006 found that women were more likely than men to access services. The 2010 National EmONC assessment shows none of the health facilities at any level achieved the goal of one skilled attendant for every 100 expected births. The ratio of midwives to 100 expected births at both the district and regional hospitals was zero and CHCs, RHs and SHs all had small ratios of 0.1.After analyzing deaths among women of reproductive age from 1999 to 2002 at four sites in Afghanistan, one assessment (Bartlett et al., 2005) estimated the lifetime risk of maternal death at one in six to one in nine. The risk of maternal death was considerably lower in urban areas and increased with remoteness in rural areas. Two more recent global reviews estimated the 2008 MMR in Afghanistan at 1600 deaths respectively, although considerable uncertainty surrounds these numbers due to lack of data. The reviews make clear; however, that maternal mortality in Afghanistan remains extremely high by international standards even though there has been some progress since the year 2000. Much work remains to be done, despite significant efforts by the Reproductive Health Directorate of MoPH in the last seven years to prioritize maternal and newborn health and increase access to services.

High infant mortality is also a concern in Afghanistan. The infant mortality rate (IMR) was estimated at 129 deaths per 1,000 live births in 2006 (MoPH, 2006), and the neonatal mortality rate at 60 per 1,000 live births in 2004 (UNICEF, 2010).

Total fertility rate is 6.6 (2008) and contraceptive prevalence rate (CPR) is 22.8% (2007). The national household survey conducted by the Ministry of Public Health (MoPH) in 2006 reported that 33% of currently married women demonstrated knowledge of at least one modern method of contraception.

The National Reproductive Health Strategy, 2006-2009, has contributed in improving the health of the people of Afghanistan, especially women and children, through implementing the basic package of health services (BPHS) and the essential package of hospital services

(EPHS) as the standard, agreed-upon minimum of health care to be provided at each level of the health system

BPHS and EPHS packages for health services of MOPH should be adopted in accordance to the national policy and strategy documents of Reproductive health during future revisions.

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