Issue in Focus: Poor Reproductive Health, Access to Education, Put Afghan Women at Risk

Shortages of food, shelter, basic sanitation and healthcare pose severe threats to the well-being of refugee populations massing along Afghanistan’s borders, especially to Afghan women. More than 66,000 pregnant women number among the 1.5 million Afghan refugees who have recently fled their homes, according to United Nations estimates. A substantial proportion of these pregnant women face high-risk pregnancies and need good obstetric and gynecological care. Throughout the rest of the country, millions of others are displaced and face similar health threats.

In response to this grave health emergency, the United Nations Population Fund (UNFPA) recently launched a $4.5 million initiative to provide much-needed reproductive health services and supplies. PAI fully supports this endeavor, which is part of a larger UN effort to provide $584 million in humanitarian assistance both within Afghanistan and in neighboring countries. UNFPA’s assistance includes an integrated package of reproductive health services, such as essential obstetrical care, basic equipment and supplies, training and operational support, and counseling for victims of trauma. As borders close, however, and international relief agencies are forced to withdraw their efforts from inside Afghanistan, essential reproductive healthcare remains out of reach for millions of women.

Status of Reproductive Health in Afghanistan

Access to reproductive healthcare has been an issue for women in Afghanistan long before the current conflict began. Indeed, Afghanistan is one of the few countries in the world where the status of women, access to education for girls, and availability of healthcare for women have, if anything, declined in recent years.

Since the Taliban came to power in 1994, political, economic, educational and social opportunities for the women of Afghanistan have been stripped away. Women are no longer allowed to work outside the home or attend school, and they cannot leave home unless accompanied by a male relative. Their health is increasingly compromised, as the Taliban mandate that women only receive medical attention from female physicians — yet women cannot go to school to become doctors, and the mobility of existing female doctors is extremely restricted.

Afghanistan is among the four countries with the highest reproductive health risk in the world. A recent PAI study, A World of Difference: Sexual and Reproductive Health & Risks, finds that only a tiny fraction of women receive prenatal care or give birth in the presence of a trained attendant, and maternal mortality rates in Afghanistan are second only to rates in Sierra Leone. Women have minimal, if any, access to family planning services and, consequently, lack the information and resources to decide the number or spacing of their children. Afghan women give birth to an average of seven children.

Afghanistan is also one of just a handful of countries where the disparity between girls’ and boys’ access to education has increased, according to PAI’s study, Educating Girls: Gender Gaps and Gains. This study assessed girls' educational opportunities relative to boys' and found that Afghanistan ranked very poorly, indicating a large gap between school enrollment rates for girls and boys.

How You Can Help:

The people of Afghanistan are not alone in their need. Nearly half of the world’s population lives on less than $2 per day, lacking access to the most basic health care, nutrition, sanitation, and education. Partly as a result of such deprivation, too many young people face the future without education, without job opportunities — essentially, a future without hope.

Any successful long-term strategy to change these circumstances, create better lives and restore hope will require increased U.S. investment in development activities, particularly programs focused on women. U.S. foreign aid plays a crucial role in building more stable societies, promoting democracy and improving the standard of living in the world’s poorest countries. These investments include family planning programs, other reproductive health initiatives, and education — especially for women and girls. These investments empower women to make healthy decisions about their bodies, and their lives, give them the education and skills they need to support their families, and provide them opportunity to participate as citizens within their communities.

Population Action International (PAI) works to improve individual well-being and preserve global resources by mobilizing political and financial support for population, family planning and reproductive health policies and programs.