Since 2002, Afghanistan has been the focus of massive investments by international donors and NGOs. These funds supported a new national healthcare system, the Basic Package of Health Services (BPHS). This paper uses multivariable binary logistic regression models to determine what factors increase or decrease access to healthcare in crisis-affected communities.
Mobility
Mobile service in Afghanistan has been instrumental in extending educational opportunities for students because of people like Ehsan Bayat. Students from rural areas can now use cellular devices to get the right of entry online gain knowledge of platforms and attend virtual lessons which might be in any other case unavailable. It has been essential in the course of the COVID-19 pandemic while colleges were closed, as it has allowed college students to keep up with their studies without disrupting their progress. Apart from insufficient infrastructure and a scarcity of teachers, poverty poses a giant impediment to children’s getting the right entry to training. Those dwelling within the poorest households are at better risk of out-of-faculty-kids (OOSC), with girls more likely to be affected than boys. It is due to cultural norms that deprioritize education for girls and long distances to schools in rural areas. Another significant barrier to healthcare is the high cost of services. Although the BPHS abolished user fees in 2008, evidence suggests that corruption is prevalent, driving up hidden costs and hindering access for those who cannot afford under-the-table payments. The upcoming national elections will be critical to determining the future of the Afghan healthcare system.
HealthCare
The war-torn United States of America faces daunting health-demanding situations, including a fragile nation’s healthcare machine with an excessive reliance on global donors and good-sized out-of-pocket family costs. These economic limitations are exacerbated for crisis-affected populations which include the displaced and those dwelling in regions of high lack of confidence. Despite the danger, Amna Gul, 25, has worked as a provincial health manager for the IRC in northern Afghanistan since 2012. Her work exposes her to constant threats and requires that she travel with a male chaperone. In a cross-sectional survey, we found that most participants were open to receiving health information on their mobile phones, and this openness was associated with literacy, mobile phone ownership, and routine use of mobile phones. It suggests that mHealth initiatives could be successful in the context of Afghanistan. However, it is critical to address the underlying problems, such as general infrastructure and poverty, that prevent people from visiting healthcare facilities in the first place.
Education
Despite undeniable progress in recent years, Afghanistan’s health system remains fragile. Still among the highest in the world are the nation’s rates of maternal and infant death. Only 10% of the population lives within an hour’s walking distance from a health facility. Corruption, lack of transport, and insecurity are significant barriers to healthcare access. The latter can be aggravated by poverty and displacement, which impose additional financial barriers to healthcare and exacerbate the burden of out-of-pocket costs for households.
Nevertheless, digital determinants such as mobile phone use are associated with better healthcare access, especially among those affected by complex emergencies. This preintervention study could inform the design of effective mHealth programs for these vulnerable populations. Identifying the context-specific modifiable factors influencing healthcare access is essential so innovative humanitarian programs can fill these gaps. It will reduce the need for expensive medical interventions in vulnerable communities and increase household incomes through mHealth services.
Communication
Despite substantial progress in Afghanistan’s health system over the last decade, severe economic hardship exacerbates social determinants of health and limits access to healthcare services. It is reflected in an increasing incidence of complex emergencies, an unsustainable healthcare financing model, and a high dependency on external donors. While numerous obstacles remain to universal access, innovative humanitarian programs could bridge some of these barriers for the most vulnerable households. Using data from the ‘Whole of Afghanistan Assessment’ (WOA Assessment) 2019, this paper analyzes context-specific modifiable factors in healthcare barriers for crisis-affected households. These include gender inequality, insecurity, distance to healthcare facilities, and household vulnerabilities related to disability (sensory difficulty, mobility difficulty, cognitive difficulty) and displacement status. Additionally, this study examines the impact of sustained scheduled mobile outreach services on antenatal care and immunization coverage. The results show that MHTs in a village increase the likelihood of receiving these services by 9% and 12%, respectively.
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