The crisis of maternal and child health in Afghanistan
Background The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement, work, political participation, and education. This study examined Afghan health workers’ experiences and perceptions of availability and qua...
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| Vydáno v: | Conflict and health Ročník 17; číslo 1; s. 28 - 10 |
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| Hlavní autoři: | , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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London
BioMed Central
12.06.2023
BioMed Central Ltd Springer Nature B.V BMC |
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| ISSN: | 1752-1505, 1752-1505 |
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| Abstract | Background
The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement, work, political participation, and education. This study examined Afghan health workers’ experiences and perceptions of availability and quality of maternal and child health care since then.
Methods
We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover.
Results
131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were “worse” or “much worse” than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings.
Conclusion
The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. |
|---|---|
| AbstractList | The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement, work, political participation, and education. This study examined Afghan health workers' experiences and perceptions of availability and quality of maternal and child health care since then.BACKGROUNDThe Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement, work, political participation, and education. This study examined Afghan health workers' experiences and perceptions of availability and quality of maternal and child health care since then.We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover.METHODSWe conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover.131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were "worse" or "much worse" than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings.RESULTS131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were "worse" or "much worse" than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings.The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population.CONCLUSIONThe combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. Background The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement, work, political participation, and education. This study examined Afghan health workers' experiences and perceptions of availability and quality of maternal and child health care since then. Methods We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover. Results 131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were "worse" or "much worse" than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings. Conclusion The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. Keywords: Maternal health, Humanitarian, Afghanistan, Women's rights The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement, work, political participation, and education. This study examined Afghan health workers' experiences and perceptions of availability and quality of maternal and child health care since then. We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover. 131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were "worse" or "much worse" than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings. The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement, work, political participation, and education. This study examined Afghan health workers' experiences and perceptions of availability and quality of maternal and child health care since then. We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover. 131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were "worse" or "much worse" than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings. The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. BackgroundThe Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement, work, political participation, and education. This study examined Afghan health workers’ experiences and perceptions of availability and quality of maternal and child health care since then.MethodsWe conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover.Results131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were “worse” or “much worse” than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings.ConclusionThe combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. Background The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement, work, political participation, and education. This study examined Afghan health workers’ experiences and perceptions of availability and quality of maternal and child health care since then. Methods We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover. Results 131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were “worse” or “much worse” than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings. Conclusion The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. Abstract Background The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement, work, political participation, and education. This study examined Afghan health workers’ experiences and perceptions of availability and quality of maternal and child health care since then. Methods We conducted a survey, using a convenience sample, of health workers from urban, semi-rural, and rural public and private clinics and hospitals across the 34 provinces, covering changes in working conditions, safety, health care access and quality, maternal and infant mortality as well as perceptions about the future of maternal and child health and health care. Interviews were conducted with a subsample of health workers to further explore their perceptions of changes in working conditions, quality of care, and health outcomes since the Taliban takeover. Results 131 Afghan practicing health care workers completed the survey. The majority were women (80%) working in facilities located in urban areas. Most female health workers (73.3%) reported that they have not always been safe when going to and from work; 81% because of harassment by the Taliban when they did not have male accompaniment. Almost half of the respondents (42.9%) reported a decrease in availability of maternal and child care and 43.8% stated that conditions for providing care were “worse” or “much worse” than before. Almost one-third (30.2%) indicated that changed working conditions negatively impacted their ability to provide quality care, and 26.2% reported an increase in obstetric and newborn complications. Health workers also reported (38.1% )an increase in sick child needs and an increase in child malnutrition (57.1%0. 57.1% reported decreases in work attendance and 78.6% a decrease in morale and motivation. Qualitative interviews (n = 10) of a subsample of survey participants expanded on these findings. Conclusion The combination of economic collapse, lack of sustained donor support for health care and Taliban interference with human rights has severely compromised access and quality of maternal and child health care. Strong and concerted international pressure on the Taliban to respect women and children rights to essential health service is critical for the future of the Afghan population. |
| ArticleNumber | 28 |
| Audience | Academic |
| Author | Spiegel, Paul Jalalzai, Rabia Glass, Nancy Rubenstein, Leonard |
| Author_xml | – sequence: 1 givenname: Nancy surname: Glass fullname: Glass, Nancy email: nglass1@jhu.edu organization: Johns Hopkins School of Nursing, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Humanitarian Health – sequence: 2 givenname: Rabia surname: Jalalzai fullname: Jalalzai, Rabia organization: Johns Hopkins University Hospital – sequence: 3 givenname: Paul surname: Spiegel fullname: Spiegel, Paul organization: Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Humanitarian Health – sequence: 4 givenname: Leonard surname: Rubenstein fullname: Rubenstein, Leonard organization: Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Humanitarian Health, Center for Human Rights and Public Health, Johns Hopkins Bloomberg School of Public Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37308945$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/S0140-6736(05)62439-7 10.1016/j.eclinm.2021.101235 |
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| Copyright | The Author(s) 2023 corrected publication 2023 2023. The Author(s). COPYRIGHT 2023 BioMed Central Ltd. 2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. The Author(s) 2023 |
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| Keywords | Humanitarian Afghanistan Maternal health Women’s rights |
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| PublicationTitle | Conflict and health |
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The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement,... The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement, work,... Background The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women's freedom of movement,... BackgroundThe Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of movement,... Abstract Background The Taliban takeover in August 2021 brought global economic sanctions, economic collapse, and draconian restrictions on women’s freedom of... |
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| SubjectTerms | Afghanistan Attacks on healthcare Availability Beliefs, opinions and attitudes Births Central banks Child care Children Children & youth Childrens health Conflict Studies Economic crisis Economics Education Emergency Medicine Employees Epidemiology Food Funding Global economy Global health Health aspects Health care Health care access Health care policy Health facilities Health Promotion and Disease Prevention Health services Health Services Research Hospitals Human rights Humanitarian Humanitarian aid Humanitarianism Infant mortality Infants International banking Malnutrition Maternal & child health Maternal health Maternal mortality Medical care Medical ethics Medical law Medical personnel Medical research Medicine Medicine & Public Health Morale Mortality Mothers NGOs Nongovernmental organizations Patient outcomes Population Professionals Public Health Quality management Quality of care Sanctions (International law) Staff participation Surveys Transfer of funds Urban areas Urban health Women's rights Womens rights Workers' compensation Working conditions |
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| Title | The crisis of maternal and child health in Afghanistan |
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