Healthcare in Afghanistan

There are over 100 government-run and private or internationally-administered hospitals in Afghanistan. The most advanced medical treatments are available in Kabul. The French Medical Institute for Children and Indira Gandhi Children's Hospital in Kabul are the leading children's hospitals in the country. The Kabul Military Hospital and the Jamhuriat Hospital are two of the most popular hospitals in the country. In spite of all this, many Afghans still travel to Pakistan and India for advanced treatment.

One of the main hospitals in Kabul, Afghanistan

Maiwand Teaching Hospital was established in the 1960s, designed to treat between 300-400 patients a day, but in 2019 there are often 1,000 patients in a day.

Infant ward at a Kabul hospital, 1960s

It was reported in 2006 that an estimated 800,000 Afghans are disabled.[1] Infant, child, and maternal mortality rates in Afghanistan reached the highest in the world, by some estimates as high as 275 per 1,000. In rural areas, one in six children die before reaching age five. This is because of poor sanitation and insufficient potable water supply, infectious and parasitic diseases such as malaria and diarrhea are very common. Malnutrition and poor nutrition also are pervasive.

Opening ceremony at a public health clinic in Kandahar province of Afghanistan (May 2012).

User fees have been a major deterrent to accessing health care. Various interventions have been devised to improve uptake of health care services, including the distribution of waiver cards to very poor and female-headed households[2] and the introduction of community-based health insurance.[3]

Following the national user fee ban in 2008, a pilot study conducted by the Future Health Systems consortium found a 400% increase in utilization of services that had previously charged fees for services and medicine.[4] The government's strategy to collaborate with non-governmental organisations[5] has led to higher primary health outcomes among the poor,[6] with relatively high levels of perceived health care quality reported by clients in a recent study of primary care services.[7]

The physical and psychological effects of war have substantially increased the need for medical care. A number of new hospitals have been established, with the most advanced treatments being available in Kabul. The French Medical Institute for Children and Indira Gandhi Childrens Hospital in Kabul are the leading children's hospitals in the country. Some of the other main hospitals in Kabul include the 350-bed Jamhuriat Hospital, the Sardar Mohammad Daud Khan Hospital,[8] and the Jinnah Hospital, which is under construction. There are also a number of military-controlled hospitals in different regions of the country. A new 350-bed hospital was constructed in 2017 in the southern Afghan city of Kandahar.[9]

In the first quarter of 2019 there were 34 reported attacks on healthcare facilities, at least 87 were closed. At least nine workers and patients were killed.

There are media reports of low-quality, fake or expired Pakistani and Iranian drugs. As many patients cannot pay for their prescriptions doctors may give them expired medicines.

Average pay for a doctor in a government hospital is between 12,000-15,000 Afghanis ($151-$189) a month. Most doctors supplement this by working after-hours at private clinics.

Mothers and infants receiving health care at a hospital in Kabul.

Afghanistan made significant improvement in the last decade to its maternal and child health care. According to United States Agency for International Development (USAID), Afghanistan's mortality rate has decreased by about 25% since 2003. It was reported in 2006 that nearly 60% of the population lives within two hours walking distance of the nearest health facility.[10]

The maternal mortality rate is currently 396 deaths/100,000 live births and its infant mortality rate is 66[11] to 112.8 deaths in every 1,000 live births.[12] The Ministry of Public Health wants to further improve these higher rates by making them normal.

The country has more than 3,000 midwives, with an additional 300 to 400 being trained each year.[13] According to Sima Ayubi, a maternity doctor in Kabul who advocates hospital births, explains: "Now pregnant women have more information about health. This mortality rate is still a problem. There's just a decrease. The problem is not completely eliminated or under control."[13]

According to a 2012 report by Save the Children, improved healthcare and the rise of females attending school have made Afghanistan climb up from its position as the worst place on earth to be a mother. "More mothers are surviving and fewer children are dying and this is something we need to be celebrating," said Rachel Maranto, Advocacy and Mobilisation senior Manager at Save the Children in Kabul.

Afghans spend an estimated $300 million a year on medical treatment abroad, mostly in Pakistan, India and Turkey.[14]

• Health in Afghanistan
• List of hospitals in Afghanistan