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Health Indicators for Mothers and Children in Rural Herat Province, Afghanistan

Published online by Cambridge University Press:  28 June 2012

Ayan Ahmed ,
Anbrasi Edward  and
Gilbert Burnham
Ayan Ahmed
Affiliation:
The Johns Hopkins Bloomberg School of Public Health, Center for International Emergency, Disaster and Refugee Studies, Baltimore, Maryland, USA
Anbrasi Edward
Affiliation:
The Johns Hopkins Bloomberg School of Public Health, Center for International Emergency, Disaster and Refugee Studies, Baltimore, Maryland, USA
Gilbert Burnham*
Affiliation:
The Johns Hopkins Bloomberg School of Public Health, Center for International Emergency, Disaster and Refugee Studies, Baltimore, Maryland, USA
*
The Johns Hopkins Bloomberg School of Public Health, Center for International Emergency, Disaster and Refugee Studies, 615 North Wolfe Street, E8132 Baltimore MD, 21205USA E-mail: [email protected]
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Abstract

Introduction:

Following years of conflict and neglect, major efforts now are underway to develop health policy and rehabilitate the health facilities in Afghanistan. As part of these efforts, there is a need to better understand the health status and health-seeking behaviors. As part of an effort to assist local non-governmental organizations (NGOs), a household survey of mothers with children under the age of five years was conducted in two rural districts of Herat Province, Karokh and Chesht-e-Sharif.

Methods:

A two-stage, 30-cluster approach was used for each district. This included 622 mothers of 926 children under the age of five years living in the two districts. Outcome measures included demographic characteristics, antenatal services, immunization coverage, hemoglobin levels of the mothers, nutritional status and practices, environmental health indicators, recent illness, and health seeking behaviors.

Results:

The mean value of ages of the mothers was 27 years with an average parity of 6.1. Less than 5% of mothers ever had attended school. Half of women had lost at least one child before the child reached the age of five years. Under-five-year mortality was estimated at 325. Only 29% of the women had attended an antenatal clinic during their last pregnancy. Virtually all deliveries occurred at home. Only 7.6% of women had received three doses of tetanus toxoid. Less than 9% of the children 12–59 months of age were fully immunized. According to the measurements of mid-upperarm circumference (MUAC), 11% of children were malnourished. Although breastfeeding almost was universal, greater than one-third of the women did not start breastfeeding until the second day after delivery. Protected water sources and appropriate control of feces were lacking in both districts. In the previous two weeks, 45.7% of children had experienced diarrhea, and dysentery had occurred in 10%. Fever had been present in one-quarter of the children.

Conclusions:

Household health indicators indicate serious maternal and child health concerns in these two districts. Of particular concern is the poor immunization coverage, lack of reproductive health service, and the prevalence of common childhood illness in these populations. The feeding practices for children and the anemia among mothers also raised concerns. Poor environmental health contributes substantially to childhood illness.Without special emphasis, efforts to rebuild the health sector are likely to reach the household level only late in the process. An aggressive program to integrate community development and promotion of sound health practices is needed to improve the health of the Afghanistan people.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 3 , September 2004 , pp. 221 - 225
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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References

1.Anonymous: Reconstruction of health care in Afghanistan. Lancet 2001;358:2009. Editorial.CrossRefGoogle Scholar
2.Porignon, D, Hennart, P: Reconstruction of health care in Afghanistan. Lancet 2002;259:1071–1072. Letter.CrossRefGoogle Scholar
3.Waldman, R, Homaira, H: The Public Heath System in Afghanistan. Available at http://www.areu.org.pk/publications.html. Accessed 24 January 2004.Google Scholar
4.Cook, J: Post-conflict reconstruction of the health system of Afghanistan: Assisting in the rehabilitation of provincial hospital – Context and experience. Medicine, Conflict and Survival 2003;19:128–141.CrossRefGoogle ScholarPubMed
5.Bilukha, OO, Brennan, M, Woodruff, BA: Death and injury from landmines and unexploded ordnance in Afghanistan. JAMA 2003;290:650–653.CrossRefGoogle ScholarPubMed
6.United Nations Children's Fund. Statistical data for Afghanistan. Available at http://www.unicef.org/infobycountry/afghanistan.html. Accessed 02 February 2004.Google Scholar
7.Woodruff, BA, Reynolds, M, Tchibindat, F, Ahimana, C: Nutrition and Heath Survey Badghis Province, Afghanistan. UNICEF and CDC: Kabul and Atlanta, 2002.Google Scholar
8.Amowitz, LL, Chen, R, Iacopino, V: Maternal mortality in Heart Province, Afghanistan, in 2002. JAMA 2002;288:1284–1291.CrossRefGoogle Scholar
9.UN Afghanistan Information Management Service: District Population per Health Worker. Available at http://www.aims.org.pk/assistance_sectors/health/health_maps. Accessed 09 March 2003.Google Scholar
10.Child Survival Technical Support: KPC 2000+Questionnaire. Available at www.childsurvival.com/kpc2000/kpc2000.cfm. Accessed 03 February 2004.Google Scholar
11.United Nations Children's Fund: MICS2 Questionnaire. Available at www.childinfo.org/MICS2/finques/M2finQ.htm. Accessed 03 February 2004.Google Scholar
12.United Nations: Estimation of Child Mortality from Information on Children Ever Born and Children Surviving. In: Manual X: Indirect Techniques for Demographic Estimation. New York: United Nations, 1983.Google Scholar
13.Afghanistan Assistance Coordination Authority: Health Sector Emergency Reconstruction and Development Project. Available at http://www.afghanistangov.org/aaca/procurement/GPNs/Health. Accessed 04 February 2004.Google Scholar
14.Dadgar, N, Ansari, A, Naleo, T et al. : Implementation of a mass measles campaign in Central Afghanistan, December 2001 to May 2002. Journal of Infectious Diseases 2003;187:S186–S190.CrossRefGoogle ScholarPubMed
15.Kaartinen, L, Diwan, V: Mother and child health in Kabul, Afghanistan with focus on the mother: Women's own perspective. Acta Obstetrica et Gynecologica Scandanivica 2002;81:491–501.CrossRefGoogle ScholarPubMed