Overcoming Barriers to Reproductive Healthcare in Post-Conflict Afghanistan: A Participatory Study

Published by Marie Stopes International (MSI) in May 2004, this 22-page publication documents a participatory study on overcoming barriers to sexual and reproductive health care in post conflict Afghanistan.

From the Abstract

"Objectives

The objectives of the study were firstly to understand barriers to the use of family planning and other reproductive health (RH) services in Afghanistan, and, secondly, identify the strategies used to overcome these barriers among couples successfully using these services. It was envisaged that this would then feed into development of effective and practical strategies to empower women and men to exercise their right to family planning and other RH services.

Methodology

Twenty nine focus group discussions were held and were split between the following categories:

• family planning users
• other RH users
• young women in the community
• older women in the community

In addition, 72 in-depth interviews were held with community men and community leaders. The research was conducted in rural and urban locations across Afghanistan including Kabul, Kapisa, Bamyan and Badakhshan.

Results

The main findings of the research were as follows:

• the ideal size of a family in Afghanistan is around four to five children, preferably with more sons than daughters. An encouraging finding is that those who prefer to have large families are in the minority;
• in post-conflict Afghanistan, the current economic situation and insecurity about the future is considered a valid reason for limiting the number of births;
• generally, family planning is given approval for economic and health reasons, although is often conditional upon a requisite number of sons being born;
• encouragingly, there is approval from groups traditionally seen as resistant to family planning, for example, male community leaders and mothers-in-law;
• all groups have major concerns about the perceived harmful effects of family planning, such as mental weakness, bleeding, infertility, eye disorders and death;
• it is imperative that a woman has permission from her husband to attend a clinic and to use family planning. Consensus between spouses is highly desirable. Men feel wives should persuade husbands with good arguments for using RH services;
• messages containing economic and health arguments, supported by doctor's opinions, carry the most weight for persuading people to take up family planning."

According to Marie Stopes International, these results have demonstrated the opportunities that are present in Afghanistan to increase the use of family planning. The findings have also given valuable input into the communications strategies of MSI: Afghanistan.

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