Access to Care in Afghanistan: Perspectives from Afghan People in 10 Provinces

Afghanistan has been affected by conflict for over 40 years. Following the Taliban’s takeover of Kabul on the 15th of August 2021, international assets have been frozen, international forces withdrawn and diplomatic delegations evacuated. The resulting economic and employment crisis, along with logistical constraints in the procurement of pharmaceuticals and medical supplies, increased the burden on humanitarian organizations to deliver essential services.

In 2022, CRIMEDIM and EMERGENCY NGO started a collaboration to carry out a mixed-methods study to investigate the main barriers to access care in Afghanistan in recent years, and how these have changed since August 2021. The project was composed by three phases, combining qualitative and quantitative methods. The results are the product of the analysis of data from EMERGENCY's facilities in 11 provinces, the dissemination of an interviewer-administered questionnaire to 1807 patients and caregivers in 10 provinces, and the conduction of 43 interviews with EMERGENCY's staff and hospital directors.

Leveraging on the expertise of the two partners, the results of this project revealed a drop in consultations in August 2021, with rates returning to normal as early as September 2021, with more patients seeking care for civilian trauma rather than war wounds. Although patients feel safer when visiting health facilities, their ability to pay for care has decreased after August 2021. Many health system-related factors impact access to care and make people go straight to larger hospitals, aggravating the congestion of patients in tertiary hospitals.

Results are disseminated in the form of an advocacy report; scientific publications will follow.