Patients in Afghanistan Face Growing Obstacles to Care | Global Health | JAMA | JAMA Network
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Global Health
July 20, 2021

Patients in Afghanistan Face Growing Obstacles to Care

JAMA. 2021;326(3):214. doi:10.1001/jama.2021.11410

Ongoing violence and instability coupled with worsening economic conditions exacerbated by COVD-19 are jeopardizing access to health care in Afghanistan, according to a survey conducted in February by Doctors Without Borders, or Médecins Sans Frontières (MSF).

Roughly half the patients and caretakers surveyed said they delayed seeking care and about one-third stopped ongoing treatment in the past year. As a result, many patients arrived in critical condition, too late for survival. Three-quarters of those surveyed said cost was a primary barrier—56% reported borrowing money and 38% sold household items or animals to pay for care. Nearly one-third said violence or security concerns led them to delay care. For example, some were unable to travel at night or they had to navigate landmines and improvised explosive devices on roads.

Patients also have faced fewer options for care because of violence targeting health care facilities. MSF was forced to close a busy maternity ward in Kabul after attackers shot and killed 24 people including 16 mothers, a midwife, and 2 children. Karsten Noko, MSF’s project coordinator in Afghanistan, cautioned in a statement that politically motivated reductions in assistance for health care could worsen conditions there.

“Rather than cutting resources, international donors and health care providers should urgently review the challenges facing Afghanistan’s patients and health system, in order to reduce barriers to care,” Noko said.