Sayed H. Mousavi,1,2,3 Guillaume Favre,1 Nooria Mohammady,3,4 Fatema Rezaie2,3 and David Baud1
1Materno-fetal and Obstetrics Research Unit, Woman-Mother-Child Department, Lausanne University Hospital, 1011 Lausanne, Switzerland (Correspondence to David Baud:
2Medical Research Center, Kateb University, Kabul, Afghanistan.
3Afghanistan National Charity Organization for Special Diseases (ANCOSD), Kabul, Afghanistan.
4Kabul University of Medical Sciences, Kabul, Afghanistan.
Abstract
Background: Afghanistan has a long history of conflict and poverty. Although reproductive, maternal, newborn and child health progressed over recent decades, availability of antenatal health facilities remains a challenge for Afghan women. Pregnant women are considered a vulnerable population for COVID-19 due to changes in their immune and cardiopulmonary systems.
Commentary: The COVID-19 pandemic and subsequent Taliban takeover significantly diminished access for pregnant women in Afghanistan to receive even minimal reproductive health care, which has increased maternal morbidity and mortality. Significant numbers of Afghan health care professionals (e.g. midwives) have been evacuated, leaving the healthcare system under-staffed, particularly in reproductive health.
Conclusion: There is an urgent need for both the international and the national communities to act on behalf of Afghan women to provide accessible life-saving supplies and medicines and improve reproductive health care facilities. 150
Keywords: women, reproductive health, MNCH, Afghanistan
Citation: Mousavi SH, Favre G, Mohammady N, Ftema Rezaie F, Baud D. The neglected fate of Afghan pregnant women’s health amid COVID-19 combined with political uncertainty. East Mediterr Health J. 2023;29 (x):xxx–xxx. https://doi.org/10.26719/emhj.XXXX Received: 31/12/22, accepted: 03/03/2023
Copyright © Authors 2023; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
Background
Afghanistan has a long history of experiencing conflict and poverty. Nonetheless, reproductive, maternal, newborn and child health have progressed over recent decades. Maternal health care improved significantly from 2003 to 2013, as demonstrated by the tripling of skilled birth attendants (from 14% to 46%), antenatal care access (from 16% to 53%) and birth in a health facility (from 13% to 39%). However, accessibility to and availability of antenatal health facilities remains a challenge for Afghan women (1).
Commentary
The COVID-19 pandemic has adversely affected all areas of health services, including maternal and newborn health (2). The Afghan health care system has faced countless challenges in tackling the pandemic, including a shortage of health care workers, insufficient testing capacity and absence of local laboratory facilities for COVID-19 testing in addition to high illiteracy rates, poor economic conditions and low public awareness (3).
Pregnant women are considered a vulnerable population for COVID-19 due to physiologic changes in their immune and cardiopulmonary systems. In pregnancy, COVID-19 is associated with severe adverse maternal and foetal outcomes, with an increased rate of preeclampsia, preterm birth, and stillbirth (4).
The rapid spread of COVID-19 in Afghanistan caused pregnant women to face even harsher realities when seeking reproductive health care. Deficits in medical equipment and supplies and fear of contracting the virus resulted in fewer individuals seeking appropriate and timely medical care, which indisputably limited antenatal and perinatal care and increased the number of home births, resulting in a rise of maternal morbidity and mortality (2).
Afghanistan has struggled with a lack of health care workers for many decades. After the Taliban rose to power, significant numbers of educated Afghans, including health care professionals (e.g. midwives), were evacuated out of the country, which left Afghanistan’s health care system under-staffed, particularly in reproductive health (5).
The COVID-19 pandemic and subsequent Taliban takeover have significantly diminished access for pregnant women to receive adequate and even minimal reproductive health care, which has increased maternal morbidity and mortality. Moreover, the absence of family planning options, resulting in a higher rate of unplanned pregnancies, limited prenatal and postnatal care and an absence of vaccines (not only for SARS-CoV-2) has potentially resulted in increased maternal and neonatal deaths. Consequently, there is real threat to the accomplishments that have been made in women’s health over the last 2 decades (2,5,6).
Conclusion
There is an urgent need to act on behalf of Afghanistan, and especially Afghan women: both the international and the national community are required to provide accessible life-saving supplies, medicine and reproductive health facilities, particularly in remote and underserved areas, as well as the COVID-19 vaccine.
Funding: None.
Competing interests: There are no competing interest.
References
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