Theses on Afghanistan Health

Title: Exploring barriers to utilization of Basic Package of Health Services (BPHS) by mothers in Afghanistan

Background: The maternal mortality ratio (MMR) in Afghanistan is high (400 per 100,000 live births) compared to the countries in the region and some of the developing countries.  Women in Afghanistan die due to pregnancy-related complications because they cannot access to the maternal services entitled to them in their own area.  

Objectives: The objective of the study is to explore underlying factors influencing mothers’ utilization of health services provided as part of the Basic Package of Health Services (BPHS) in Afghanistan from the demand and supply side perspectives. This is done to provide evidence informed practical solutions to tackling both types of barriers concurrently, leading to clear recommendations for improvement of the health system in Afghanistan.

Method: A descriptive study based on literature review.

Findings:  There is still a high maternal mortality in Afghanistan because of underlying factors that hinders the access of women to healthcare services. Most geographically hard to reach provinces have poorly functioning health services. There is still a huge gap in access to skilled birth attendance across the country. In addition, in some areas with insecurity, women cannot access health services. Despite the fact that health services are free, there is huge out-of-pocket expenditure for health care and inequitable distribution of services. The indirect cost, social norms, women’s education, cultural and behavioral factors impede access to health services.   

Conclusion: Women of childbearing age remain vulnerable to disability and death (morbidity and mortality) due to lack of access to maternal health service particularly emergency obstetric care. The multi-faceted barriers can be removed if targeted policies, political will, balanced sectorial development and financial means are in place. The piloting of innovative approaches to service delivery can contribute to the longer-term strengthening of maternal health services.         

Word counts: from chapter one up to end of chapter five 11,397 words

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