Kabul, 28 October 2023 (TDI): In Afghanistan, maternal mortality remains a dire and pressing concern, as one mother is believed to lose her life approximately every two hours due to preventable complications during pregnancy and childbirth.

Numerous factors, such as cultural norms and societal restrictions that restrict women’s access to necessary healthcare services, exacerbate this tragic situation.

One significant challenge Afghan women face is the practice of mahram, which enforces strict limitations on women’s mobility. According to this custom, women are prohibited from leaving their homes without a male relative accompanying them.

Additionally, this practice prevents them from receiving medical care from male doctors, making it challenging for women to access healthcare independently and participate in their own health decisions.

The result is that many women, particularly in conservative rural areas, are denied the opportunity to seek timely medical assistance during pregnancy and childbirth, leading to preventable maternal deaths.

Despite some progress in reducing maternal mortality over the past two decades, the return of the Taliban in August 2021 has raised significant concerns.

The Taliban’s reimplementation of strict and regressive policies, such as banning girls from attending school beyond the sixth grade and restricting women from pursuing higher education and employment opportunities, further hampers women’s access to healthcare.

Additionally, women must now wear the all-encompassing burqa and can only leave their homes with a male relative.

The Taliban’s return also threatens women’s ability to access healthcare facilities for maternal and newborn care, further compounding the maternal mortality crisis.

While no nationwide statistics have been released since 2020, reports from the Afghan Association of Obstetricians and Gynecologists suggest that maternal mortality has only slightly increased under Taliban rule.

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However, Afghanistan still ranks among the world’s top 10 countries with the highest maternal mortality rates, with 638 maternal deaths per 100,000 live births.

The challenges facing Afghan healthcare are multifaceted. The departure of a significant number of doctors as the Taliban regained power, a struggling economy, and numerous humanitarian crises have all put additional strain on the healthcare system.

The healthcare sector has also suffered from a dramatic drop in international funding since the Taliban takeover, exacerbating the situation.

The continued involvement of outside organizations like private hospitals, the UNFPA, and Doctors Without Borders (MSF) has helped to mitigate some losses, but they also present their own set of difficulties.

Even in the health sector, the ban on female humanitarian workers by the Taliban has indirect effects, limiting the efficient delivery of healthcare services.

Female healthcare workers, in particular, have faced obstacles in carrying out their work and expanding their expertise, despite the growing severity of factors contributing to maternal mortality.

Fear and restrictions on mobility have prevented many midwives and healthcare professionals from providing essential care.

Efforts to address the maternal mortality crisis in Afghanistan continue. Organizations like MSF operate projects focused on maternal healthcare and employ over 1,700 medical professionals in the country, with more than half being women.

The UNFPA remains committed to providing maternal health services in Afghanistan, even in the face of challenges.

However, the situation is far from resolved, and there is a pressing need for sustained support for reproductive health services to prevent an estimated 51,000 additional maternal deaths by 2025.

Strengthening primary healthcare, improving the status of women, and ensuring the availability of female healthcare workers are crucial steps needed to combat the maternal mortality crisis in Afghanistan.

The current humanitarian crisis is a complex challenge that requires urgent attention from policymakers, donors, and local authorities to save the lives of Afghan mothers and newborns.