Study reveals access to quality health care has fallen sharply in Afghanistan

Despite 15 years of investment in the Afghan health care sector by the international community, a new study in Lancet Global Health has found that access to quality care has fallen significantly for vulnerable groups including people with disabilities.

The study used data from two representative household surveys from 2005 and 2013, held in 13 provinces of Afghanistan. Surveys included questions about activity limitations and functioning difficulties, socioeconomic factors, perceived availability of health care and experience with coverage of health care needs.

The study found that there was a striking 25 percent increase in the proportion of survey respondents for whom health care was not available between 2005 (31%) and 2013 (56%), and a similar rise in the number of respondents whose said that the coverage of their health care needs was negative (23% to 55%).

Respondents with disabilities in the 2013 survey were over three times less likely to report availability of health care than those in the 2005 survey.

Even after taking village remoteness into account, the time for people with disabilities to reach a health care facility was longer, and connectivity by paved roads was worse in 2013 than in 2005.

To reverse this trend, a multilevel intervention is necessary to meet the United Nations’ Sustainable Development Goal 3 of universal healthcare coverage.

We must promote a community-based health care and education system to promote hygiene and prevention of diseases, treat common childhood disorders, communicable diseases, such as malaria, and provide basic reproductive health advice, which will contribute to the prevention of many disabilities.
Jean-Francois Trani of Washington University’s Institute for Public Health - lead author

“We also need to train community health workers to assess disabilities, address stigma associated with disability and increase referral and providing of free transportation and free access to hospitals. Yet, such a program will only be effective if a political solution to the ongoing conflict is successfully sought,” he said.

The University of Manchester’s Tarani Chandola was a co-author of the study, which was funded by the Swedish International Development Agency.

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