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.