Background Afghanistan has one of the highest maternal mortality ratios throughout the world. According to AFDHS 2015 the maternal mortality ratio in Afghanistan is 1200/100000live births. Anecdotally, lack of access and very low utilization of maternity services due to limit access low quality of services and cultural barriers seems to have an important role in such a high maternal mortality. However, to date there are very limited studies looking at reasons and strategies for addressing maternal mortality in Afghanistan. Despite the highly important role of access in reducing maternal mortality.
OBJECTIVE The objective of this study was to provide qualitative and quantitative information on reproductive health inhabitants’ knowledge, attitude and practices in Laghman province of Afghanistan.
METHODOLOGY This field research used two types of assessment, qualitative and quantitative. These two different sets of data triangulated each other and provided an exhaustive picture of access to health and health seeking behaviors of the beneficiaries. The data was later entered into Epi Info version 7.2.01(CDC, 2016) and analyzed using the same software with a confidence interval of 95%.
RESULTS Total, 187 male heads of households and 187 mothers, 8 Focus Group Discussions (FGDs) and five key informants from health facility and stake holder were the participants in this study with age range of 1555 years. The survey found that the distance seems to be one of the biggest barriers to access health care there are several factors discouraging women from attending BHC, especially for deliveries and those are mainly to be attributed to the health services supply side and demand side. Patients believe the quality of care offered often is not up to the standard they expect and since they have other available care options. Other contributing factors like privacy issues, unavailability of 24/7 maternity care services especially during night. and not having a transportation mean most of the time owing people to walk for hours to reach the health centers from the services users’ side, keeping in mind the low socio economic situation of the communities, although people are aware about the existing of health services care
CONCLUSION The finding suggest to incentivize deliveries assisted by skilled personnel, the implementer NGO could think about organizing family and delivery homes in strategic places where a skeleton skilled staff from the BHC – e.g. midwife – is present to assist deliveries 24/7 or alternatively thinking about having a backup midwife at provincial level to ensure continuity of services deliveries.