Reproductive Health in Afghanistan: Results of a Knowledge, Attitudes and Practices Survey among Afghan Women in Kabul

Abstract

A reproductive-health knowledge, attitudes and practices (KAP) survey was carried out among 468 Afghan women of reproductive age. A convenience sample of women was selected from attendees in the outpatient departments of four health facilities in Kabul. Seventy-nine per cent of respondents had attended at least one antenatal consultation during their last pregnancy. Two-thirds (67 per cent) delivered their first child between 13 and 19 years. The Caesarean-section rate was low (1.6 per cent). Two-thirds (67 per cent) of deliveries occurred in the home. The contraceptive prevalence rate was 23 per cent (16 per cent modern and 7 per cent natural methods). Twenty-four per cent had knowledge of any STIs, although most of these women did not know correctly how to prevent them. Most of the women (93 per cent) needed authorization from their husband or a male relative before seeking professional health-care. In multivariate analysis, women's schooling was significantly associated with antenatal-care attendance (AOR 4.78), institutional delivery (AOR 2.29), skilled attendance at birth (AOR 2.07) and use of family planning (AOR 4.59). Reproductive-health indicators were noted to be poor even among these women living in Kabul, a group often considered to be the most privileged. To meet the reproductive-health needs of Afghan women, the socio-cultural aspects of their situation--especially their decision-making abilities -- will need to be addressed. A long-standing commitment from agencies and donors is required, in which the education of women should be placed as a cornerstone of the reconstruction process of Afghanistan.

Social Determinants of Maternal Health in Afghanistan: A Review

“…31 Two studies revealed that 83% and 75% of women respectively, expressed the view that it was a wife's duty/obligation to have sex with her husband even when she did not want to have sex. 9,10 In the same study, 93% of women said that they needed authorization from their husband or a male relative to seek professional health care. 10 In addition, published studies reported that that around half of the female respondents (45% and 56% respectively) reported that it was the right of a husband to beat his wife when she disobeys.…”

“…10 Women's education, irrespective of other socioeconomic factors, had positive contribution to improved reproductive health. 10 …”

“…15,27,32,[36][37][38][39] One study in the capital city revealed the mean age at marriage was 17.2 years with 16% married at age 14 or younger. 10 Another study in rural western Afghanistan found that 47% of women became pregnant before the age of sixteen. 31 Two studies revealed that 83% and 75% of women respectively, expressed the view that it was a wife's duty/obligation to have sex with her husband even when she did not want to have sex.…”

“…31 Egmond et al found that in the capital city of Kabul that 64% of the women participating in the reproductive health survey never attended a regular school, and 62% were illiterate. 10 A study by Khorrami and his colleagues found that higher levels of education were associated with lower rates of hemorrhagic complications during pregnancy. 34 spacing, family planning, and their overall health.…”

“…34 spacing, family planning, and their overall health. 10,16,29,34,35 Studies found that educated women recognize emergency obstetric complications and seek medical care immediately 34 , receive antenatal care, use skilled birth attendants, use contraceptives 10,16,35 , and have lower rates of adolescent pregnancies. 10 Women's education, irrespective of other socioeconomic factors, had positive contribution to improved reproductive health.…”