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FEATURE STORY March 29, 2018

Afghanistan: Women in Kandahar Province Receive Better Health Services

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Women in Kandahar Province in southern Afghanistan traditionally delivered babies at home which sometimes translated into higher incidence of mortality for mother and child. However, since establishment of the Azam Qala Basic Health Center in 2015, this trend has changed and there now are at least 20 childbirths at the center each month.

Photo Credit: Rumi Consultancy/World Bank


STORY HIGHLIGHTS

  • A health center in Kandahar Province is seeing more female patients and healthy deliveries as a result of community campaigns to raise public awareness and increase trust in health care services.
  • The campaigns are part of the efforts of the System Enhancement for Health Action in Transition (SEHAT) program to expand the scope, quality, and coverage of health services to Afghanistan, particularly for the most vulnerable.
  • At the same time, almost all health centers in the province under SEHAT have recruited women health professionals to meet the needs of female patients and address maternal and infant mortality.

DAMAN DISTRICT, Kandahar Province – In Afghanistan, especially in rural areas, access to health care is not simply about the facility being in place but more about communities deciding to trust modern medicine. This is especially true when it comes to women’s health and childcare.

A landlocked district, Daman is one of the more conservative districts in Afghanistan. The lack of facilities in the district is exacerbated by widespread misgivings about seeking access to health care services. .

This was the situation until recently in Azam Qala village in Daman district, which is served by the Azam Qala Basic Health Center (BHC). The BHC was established as a small health center 30 years ago, but even up to five years ago, it did not report any cases of childbirth because of traditional restrictions coupled with the lack of female health professionals. “Till a few years ago, we had no cases of pregnant women or childbirth at the health center,” says Azizullah Azami, 24, supervisor of the Community Health Workers at the BHC.

The situation, however, has changed since July 2015 when Bu Ali Rehabilitation and Aid Network (BARAN), a nongovernmental organization (NGO), was contracted by the Ministry of Public Health (MoPH) to implement Basic Package of Health Service (BPHS) financed by System Enhancement for Health Action in Transition (SEHAT) Program in Kandahar.


"We come for treatment and also bring our children to the nutrition department. The doctors are nice and solve all our problems."
Rahm Bibi
resident, Hijran village, Kandahar Province


Raising Awareness of Health Services

With support from the SEHAT Program, the BHC team decided to approach the communities to raise awareness and increase trust in its staff and services. says Azizullah as he prepares for a visit to a nearby village for an information session on seasonal diseases. “With access to quality health services, public awareness will also improve,” he says.

Low public awareness of health and health services, however, remains a challenge. “People now think that more drugs are good, but we do our public awareness campaigns and they are changing the view of people,” says Dr. Sardar Mohammad, 50, head of Azam Qala BHC.

SEHAT aims to expand the scope, quality, and coverage of health services provided to the population, particularly for the most vulnerable. It is supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors.

Under SEHAT, a basic package of health services and essential package of hospital services are made available across Afghanistan. , such as BARAN, which deliver health services as defined in these packages. 


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Under the SEHAT Program, the Ministry of Public Health contracted the Bu Ali Rehabilitation and Aid Network (BARAN), a nongovernmental organization (NGO) to provide basic health services in Kandahar Province.

Photo Credit: Rumi Consultancy/ World Bank


Building Community Trust

Azam Qala BHC, on the Kandahar-Kabul main road, sees more than 70 patients daily, providing the basic package of free health services defined by SEHAT. Located more than 20 kilometers from Kandahar city, the provincial capital, the BHC serves more than 13,000 people in Daman district.

Under SEHAT, BARAN has also prioritized the hiring of female health workers in the health centers it covers in Kandahar Province, including Azam Qala BHC. Today, 50 out of 51 health facilities supported by SEHAT in Kandahar have female health workers to meet the needs of female patients and address maternal and infant mortality. Azam Qala BHC itself has three female employees out of seven. “We provide the full range—midwifery services, family planning, nutrition, and hygiene,” says Maroofa, 28, a midwife at the clinic.

. Today, Mohammad Jan and his wife walked for nearly 40 minutes to Azam Qala BHC for a scheduled antenatal checkup; a trek they clearly did not mind. The couple is expecting their second child and the midwifery department of the health center houses staff and doctors they trust. “This health center is a good facility for me and for others from my village because we have no money to go to other health centers as they are faraway,” says Mohammad Jan, 25, who lives in Kantinaran village, as he waits their turn.

Rahm Bibi, 60, a resident of Hijran village, agrees that the health center has been very beneficial. She has brought her grandchild for a nutrition consultation.



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