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Int Health. 2015 May;7(3):169-75. doi: 10.1093/inthealth/ihu086. Epub 2014 Dec 9.

Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.

Author information

1
Médecins Sans Frontières-Operational Centre Brussels, Advocacy and Analysis Unit, Brussels.
2
Médecins Sans Frontières-Operational Centre Brussels, Afghanistan Mission, Kabul.
3
Ministry of Health-Afghanistan, Direction Ahmad Shah Baba District Hospital, Kabul, Afghanistan.
4
Ministry of Health-Afghanistan, Direction Boost Provincial Hospital, Helmand, Afghanistan.
5
Médecins Sans Frontières-Operational Centre Brussels, Operational Department, Brussels.
6
Médecins Sans Frontières-Operational Centre Brussels, Operational Research Unit, Brussels.
7
Médecins Sans Frontières-Operational Centre Brussels, Advocacy and Analysis Unit, Brussels mit.philips@brussels.msf.org.

Abstract

BACKGROUND:

The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services.

METHODS:

Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member.

RESULTS:

To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year.

CONCLUSIONS:

Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare.

KEYWORDS:

Afghanistan; Armed conflict; Delivery of health care; Health service accessibility

PMID:
25492948
PMCID:
PMC4427534
DOI:
10.1093/inthealth/ihu086
[Indexed for MEDLINE]
Free PMC Article

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