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Insurgency, insecurity threaten health progress

Women receive medical care in Esteqlal hospital in Kabul.
(Manoocher Deghati/IRIN)

Up to 100,000 people have been deprived of access to basic health services in different parts of Afghanistan over the past four months, due largely to worsening insecurity, with attacks on health workers and health centres, the Ministry of Public Health (MoPH) said.

[Listen to the audio report in Dari and Pashto]

The new figure is in addition to the over 300,000 people who last year lost access to primary health facilities, mostly in the volatile south and southeast.

“Currently some 400,000 people in the country do not have access to basic health services because of attacks on health personnel and health centres, and also due to lack of security for health workers,” Abdullah Fahim, a spokesman for the MoPH, told IRIN in Kabul on 23 July.

About 32 health centres were torched, destroyed and/or closed down due to insecurity in 2007. Over the past four months 19 health facilities have been shut down or attacked, MoPH said.

Over 50 health centres inactive

“At present more than 50 health centres are inactive; some were torched or destroyed, others remain shut because of direct threats to health workers,” Fahim said.

No health services for 400,000 Afghans
2007 - 32 health centres out of service
Jan-July 2008 - 19 health centres attacked or closed down
125 infant deaths per every 1,000 live births
Source: MoPH

Afghanistan has one of the highest maternal and infant mortality rates in the world, according to the World Health Organization (WHO).

Every hour at least two Afghan women die from obstetric complications and lack of health services. At least 125 infants die in every 1,000 live births, and one in every five children die from mostly preventable diseases before their fifth birthday, the UN Children’s Fund (UNICEF) and the MoPH reported in 2008.

These figures may not look good, but they still reflect marked progress in a country where until 2002 only 9 percent of the population had access to health services and 165 infants were dying in every 1,000 live births, according to MoPH.

After over two decades of conflict, Afghanistan began rebuilding its health sector almost from scratch in 2002, with donor funding and technical support.

“The Infant mortality rate has reduced by 26 percent and now 80,000 fewer infants are dying each year compared to during Taliban rule,” the World Bank said in a statement on 20 July.

Hard-won achievements at risk

But intensifying armed conflict and continued attacks on health workers have not only made further progress difficult, but also put the nation’s hard-won health achievements at serious risk.

“Our progress in reducing maternal and infant mortality has been threatened,” Fahim said, adding that three polio cases had been reported in the largely inaccessible southern provinces in 2008.

The Afghanistan National Development Strategy envisions that maternal and infant morality rates go down by 75 percent by 2020, and 90 percent of the country’s estimated 26.6 million people should have access to basic health services by 2010.

“We call on the Taliban to respect the neutrality of health services and stop attacking health workers and health centres,” Abdullah Fahim said.

“We also call on the government to improve security and ensure the safety and protection of health workers,” he added.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

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