Public health care in Afghanistan: An investigation in suboptimal utilization of facilities

Abstract

Afghanistan has made strides in increasing access to health care services since 2001 however it is still battling with poor utilization of services. In order to enhance demand for services a study was conducted to explore answers to the questions on knowledge, attitude and practices of communities in relation to healthcare services. The study design was cross-sectional qualitative spanning in six provinces representing geographical and ethno cultural regions of the country. In each of the six provinces, two districts were selected through mixed sampling technique representing urban-rural population. A total of 48 villages were selected in twelve districts. The study was conducted from September 2009 to March 2010. The study highlights poor heath seeking behavior associated with physical accessibility including high cost of transportation, socio-cultural barriers for women, awareness and trust for public health facilities. The system based issues adds to prevailing access related barriers such as privacy, efficiency and availability within health facilities; lack of female physicians and, aspects of behavior and attitude, and governance issues.