Building strong, trusting relationships between community health workers and the communities they serve before public health emergencies can help ensure continuity of care-seeking behaviors during times of crisis. When health services dropped during the COVID19 shutdowns, female community health workers increased their services by 25%.
The context
Even before the COVID-19 pandemic, Afghan women and girls of reproductive age faced significant health risks. An estimated 638 women died per 100,000 live births each year, about 40% of pregnant women had not received adequate antenatal care, and skilled birth attendants were present for only about half of all deliveries.i ,ii To increase access to maternal health care and primary health care, the Afghan Ministry of Public Health has established a set of basic health services in rural communities. However, urban areas are not covered by this package and have been largely excluded from government and humanitarian healthcare initiatives. Most cities have private hospitals and clinics, but urban communities are often more complex in their social structure, which can hinder access and affordability of their services. The availability of community-level health services in urban areas is limited, and issues such as gender and social norm barriers, insufficient medical personnel and supply of essential drugs, and low awareness further impede women’s access to and use of maternal care services.iii The Afghan health system has been further weakened by the COVID-19 pandemic. Many health facilities have closed due to lack of medicines, essential supplies and lack of funds to pay the salaries of health workers. As of February 2022, fewer than 10 of the country’s 37 public COVID-19 health facilities were still functional.iv Only 10% of the population is fully immunized, and displacement caused by the ongoing conflict has intensified the scale and spread of the virus.
Other challenges include a prolonged drought and a measles outbreak that has infected thousands of people since the start of 2022, as well as earthquakes in June and July 2022, further depleting existing resources and creating even greater pressure. big on the healthcare system. v
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