Reproductive Health in Afghanistan
Abdul Karim Abawi
Dr. Abdul Karim Abawi
Geneva Foundation for Medical Education and Research
karim.abawi@gfmer.org
After more that two decades of war, Afghanistan faces big challenges in the process of reconstructing of its health system and this for many years to come. The health system has been battered and bruised over several years of war. Human resource building remains the biggest challenge. Shortage of skilled staff, particularly females, may be one of the biggest constraints to scaling up health services delivery, lack of infrastructure, weak managerial capacity, socio-political situation, problematic geographical access in some areas.
Health indicators for women in Afghanistan present the worst records in the world. The national survey conducted by UNICEF/CDC/MOH in 2002 estimated the maternal mortality and morbidity at 1600/100000, which strikingly varies throughout the country (400 to 6500/100000). Almost half of all deaths among women of childbearing age are results of pregnancy and childbirth. More than 75 percent of these deaths are preventable. Main causes of such a high maternal mortality are the scarcity of qualified providers of maternal and newborn care, namely midwives, and the lack of adequate support to update medical professionals in evidence-based clinical principles and international clinical standards. Moreover women have little control over their sexual lives, as well as their fertility, which put them in a critical reproductive health status.
It is worth mentioning that during the more than two decades of war and conflict, Afghanistan was excluded from international debates on health issues and the country obviously lags behind other developing countries in terms of education and research in health sciences, its ability to provide highly trained human resource, value added products and services.
In Afghanistan medical education institutions have been introvert, self- centred even before the war and during 25 years of war they became more oblivious of the role of other disciplines in contributing to modern advances in education, research and innovations in health sciences occurring elsewhere in the world. Thus, the institutions of health science education, failed to provide an environment favourable to quality research. Medical universities and teaching hospitals failed to follow the evolutions compelling support for integrated multidisciplinary approach in the field of research.
The geographical, social and economic environment of Afghanistan warrants research on problems related to reproductive health and there is a need that national medical institutions attach a high priority to research project with international collaboration and interaction. The collaboration can be facilitated by joint working with international bodies like WHO and other specialized institutions in the field of research.
Research is essential in improving the quality of health system and developing new initiatives and help the health system to deal with the lack of evidence based policies. Information generated by research can strengthen the scientific foundation of health policy at national and international levels and help the decision makers to adapt the policy according to the real needs of population for health care.
Based on the national priorities identified by the Government of Afghanistan in field of reproductive health and in accordance with the mission and policy statement of the Ministry of Health, for rebuilding health system, the Geneva Foundation for Medical Education and Research plans to design a project with tow main components: Provision of training and conducting research projects. In order to avoid any duplication, it will take into account current and planned projects of other stakeholders in the filed of reproductive health, especially Afghan Ministry of Health, WHO, UNFPA, UNICEF and other NGOs. It is envisaged that the collaboration between GFMER and MOH will be based on a long term, during which more workforce will be trained and research projects will be designed in response to the real need identified in the field of productive health.
Publications
- Afghanistan, l’analyse de la situation, Switzerland, in collaboration with Alessandro Monsutti, Switzerland 2002
- Afghanistan zwischen Zerstörung und Aufbruch for Vielfalt, the monthly revue of Société pour des peuples menacés, an organization for the defence of human rights Bern, Switzerland, 2002
- Mise en place d’un centre de transfusion sanguine à Kaboul (Afghanistan), for Cahiers Santé, France. In collaboration with Bernadette Dupire 1999
- Guide for Maternal and Child Health (in Dari), 1995
- Immunization Survey in Afghanistan (in Dari), 1995
Links
Edited by Aldo Campana,