Findings from Salam Watandar’s interviews with eight obstetrics and gynecology specialists, as well as 30 women who have gone through pregnancy show that the programs by the Ministry of Public Health under the Islamic Emirate and other health institutions in Afghanistan have “failed” to fully address the challenges faced by pregnant women.
While obstetrics and gynecologists acknowledge that these programs have been beneficial, they believe that, given the high rates of maternal mortality, the birth of babies with congenital disabilities, and the condition of patients visiting health centers, these programs have not been able to cover all women in Afghanistan.
In this report, eight obstetricians were interviewed, and all confirmed the shortage of healthcare services for women in the Afghanistan. They emphasized that these challenges are more severe in provinces and remote areas.
Sahar Bozorgmehr, an obstetrics and gynecology specialist, says, “Mothers are still facing many problems. In villages, there is a shortage of female healthcare personnel and trained staff. In some areas, there are none, and women have no access to healthcare. Maternal mortality remains high, and the program needs to be expanded.”
Farida Reha, another obstetrician, also adds, “Mothers don’t even know how to manage the spacing between births. They lack knowledge about child nutrition and upbringing. Awareness isn’t as widespread as it should be. It isn’t just about maternal mortality, but also the disabilities that arise due to mothers’ lack of awareness. My suggestion is that the Ministry of Health and the World Health Organization should hire specialists for remote areas to ensure proper awareness, which will reduce maternal mortality and disabilities.”
Obstetrics specialists believe that neglecting the health of mothers during pregnancy can lead to maternal deaths. As a result, maternal mortality remains high in Afghanistan due to the lack of healthcare during pregnancy.
They emphasize that maternal illness or death can have negative impacts on the health, living conditions, and mental well-being of their children, which can affect society as a whole.
Doctors recommend regular visits to healthcare providers during pregnancy and stress that mothers should receive psychological support from their families, especially their husbands.
Parwin Zahed Aziz, an obstetrician, explains, “Pre-pregnancy care is the first step. Women should visit obstetricians and follow the advice given. They should plan a healthy diet and begin taking vitamins three months before pregnancy to maintain their health and that of their baby. They should avoid environmental toxins, maintain a healthy weight, and ensure they are in a good mental state.”
Meanwhile, the Doctors Without Borders organization/Médecins Sans Frontières (MSF) sent a message to Salam Watandar, stating that the Afghan public health system is severely resource-deficient and cannot meet the needs of women in Afghanistan.
According to this organization, in many cases, patients, especially women and children, arrive too late at health centers, and their problems become more complicated.
MSF also points out that the shortage of female healthcare workers in Afghanistan, especially in obstetrics and pediatrics, is another challenge faced by the country’s public health system.
A medical coordinator for Doctors Without Borders in Bamyan and Herat, told Salam Watandar in a statement: “In Afghanistan, the situation is especially difficult for women due to challenging economic conditions, restrictions on their ability to go out to fulfill their potential, limited access to education, and lack of work rights. We know that there is a shortage of female healthcare workers in Afghanistan. This affects the availability of healthcare, especially in obstetrics and pediatrics, as these areas often require women-only services. Some practices, like the need for women to be accompanied by a relative or not being allowed to make decisions about their treatment options, affect their access to maternal care and related services.”
The MSF official further noted: “In Afghanistan, the situation, especially for women, is challenging due to the difficult economic conditions, restrictions on their mobility for the purpose of talent development, limited access to education, and the difficulty for NGOs in providing work opportunities. We know that the number of female healthcare workers in Afghanistan is insufficient. This affects the availability of healthcare in the country, as obstetrics and gynecology departments, and sometimes pediatric departments, are often designated specifically for women. Some practices, such as the requirement for women to be accompanied by a relative or the lack of autonomy in making decisions about their own treatment options, impact their access to maternal healthcare and other related services.”
Additionally, findings from Salam Watandar’s interviews with 30 women who have gone through pregnancy reveal that even some women living in the country’s major cities still face health challenges due to a lack of awareness and limited access to healthcare services.
Zakia from Takhar, says: “When I get close to my delivery, I ride a pack animal (donkey) to reach the clinic. When I get to the clinic, I start bleeding. I lost several children along the way.”
These women list various challenges they faced during pregnancy, such as long distances between their homes and health centers, poor road conditions, and a lack of knowledge about pre-pregnancy care, all of which led them to suffer from various health issues during their pregnancies.
Farzana, a living in Yakawlang, Bamyan, says: “Due to lack of access to health centers and a lack of nutritious foods, I developed malnutrition.”
In light of these issues, Husna Raofi, a women’s rights activist, believes that women’s denial of healthcare rights limits their ability to play an effective role in society.
“Denial of women’s healthcare rights prevents them from functioning properly in society, which can worsen the human rights situation in Afghanistan. The inequalities in access to healthcare can exacerbate not only economic inequalities but also cultural, political, and societal issues, undermining the foundational systems of a country,” she said.
Legal experts consider access to healthcare services a fundamental right of citizens and emphasize the prioritization of this right for women. Mohammad Rahimi, a legal expert, said: “Every person has the right to healthcare, regardless of gender. Women have the same rights as men. When a woman is sick or pregnant or faces any health issue, there should be a place to address her problems. If such facilities are absent, her fundamental human rights are being violated.”
Salam Watandar attempted to obtain a response from the Ministry of Public Health under the de-facto government of the Islamic Emirate regarding this issue, but despite repeated efforts, no response was received.
Women continue to voice their concerns about health challenges and lack of access to healthcare, even as the World Health Organization (WHO) reported that the European Union had allocated 16 million euros to the WHO and 15 million euros to the UN Population Fund in 2024 to improve the quality of services in non-communicable diseases, including cancer, and expand reproductive healthcare services for mothers, newborns, children, and adolescents in Afghanistan.
According to the WHO report, maternal, child, and newborn mortality rates in Afghanistan remain among the highest in the world, with one mother dying every two hours from preventable pregnancy and childbirth complications.
