Overview of Status of Women’s Health in Afghanistan

Dr. S. M. Amin FatimieMinister of Health

Islamic Republic of AfghanistanWashington D.C.

14 July 2009

Progress has been made

Access to health services is improving

Quality of health services is improving

Provision of health services is focused on children,

women and the poor

Mortality rates of children and women are declining

Improved health system and well designed health

policies and strategies

Expansion of Health Facilities

2002 2008

Expansion of Access – Population per Health Facility

2002 20081-25,000

25,000 – 50,000

> 50,000

No health facility

Legend

Improved Access to Primary Health Care

0

5

10

15

20

25

30

35

2003 2005 2006

% of pregnant women receiving care from a skilled provider

% of women delivering assisted by a doctor, nurse or midwife

Source: MOPH/Johns Hopkins Afghanistan Household Survey, 2006

Reduced Child Mortality

* Estimate for 2000 from 2002 State of the World’s Children, UNICEF** Estimate for 2004/05 from 2006 Afghanistan Household Survey, Johns Hopkins and MOPH

257

165191

129

50

100

150

200

250

300

Under Five Mortality Rate (per1000 live births)

Infant Mortality Rate (per 1000live births)

2000 2004/5

The Tragedy of Badakhshan

Despite the progress, there are still challenges

One out of every 16 pregnant women in Badakhshan province dies as a result of pregnancy

The average woman in Badakhshan becomes pregnant about 8 times; each time her chance of dying is 1 in 16.

What is causing all these deaths?

Causes are medical, socio-cultural, geographical and logistic

Medical causes: post-partum hemorrhage, obstructed labor, infection, eclampsia

Socio-cultural causes: low levels of female literacy, persistent poverty, lack of a skilled birth attendant at delivery, early marriage, and the low status of women

What is causing all these deaths?

Geographic causes: mountainous, rugged and remote terrain with no roads

Logistic causes: no transportation (helicopters, ambulances, etc.), hospitals lack the staff and equipment to provide emergency obstetric care

So what can be done?

Community-based interventions, to bring services to the community

Train community midwives- we now have 27 midwifery education schools

Increase deliveries with skilled birth attendants

So what can be done?

Continue to strengthen the quality of health services

Continue to strengthen access to C-sections and blood at health facilities

More health facilities and equipment to enable women and children to access them

Women’s health in Afghanistan

Although reducing maternal mortality is our highest priority, there are other aspects of women’s health that are also extremely important

So what can be done?

Continue to educate women Work with community &

religious leaders to encourage them to support & promote health seeking behaviors

Develop and implement policies and laws to empower and protect women and children Gender-based violence

law

Conclusions

The health of Afghan women and children is in a better state today than in 2002

Our capacity to manage the health system is improving

The financial and technical assistance from the United States has been crucial in saving lives and improving the health status of the women and children of Afghanistan

We have achieved much with your help, but much remains to be done