Afghan Women’s Health and Lives on the Brink

By Julie Rank

The following article is based on results from the newly released 2021 report on the Hologic Global Women’s Health Index, a comprehensive global survey on women’s health. The Index surveyed women in Afghanistan for the first time in 2021.

Life was already extremely difficult for Afghan women before the Taliban returned to power in late 2021. Gallup surveys in the years leading up to the takeover showed women were struggling to afford food and shelter, few felt safe, and most saw their lives getting worse with every passing year.

Results from the 2021 Hologic Global Women’s Health Index survey in Afghanistan demonstrate how millions of Afghan women’s lives are on the brink.

In the first half of 2021, the Taliban’s attacks on healthcare facilities left 12 health workers dead and 26 buildings damaged. At the time of the survey in August and September 2021, completed as the Taliban took control of the country, Afghanistan’s healthcare system was on the verge of collapse. Essential health facilities, medications and vaccinations were scarce.

Against this backdrop, relatively few Afghan women reported getting tested for high blood pressure, diabetes, cancer or sexually transmitted diseases or infections (STDs/STIs) in the 12 months prior. In fact, no Afghan women — zero respondents — said they had been tested for any type of cancer in the past year.

But even if women had been tested for cancer, cancer treatment is not readily available in most of the country. Just one hospital in Kabul bears the treatment burden for the entire country, which had a population of more than 39 million in 2021.

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The fact that women in Afghanistan were not getting medical tests does not mean they do not value visits to healthcare professionals. Seventy-one percent of Afghan women said they believe in the value of going to a healthcare professional, and 61% said they had been to a healthcare professional in the past 12 months.

However, access to these professionals will likely remain a challenge: In 2020, roughly one in three Afghans had no access to a functional health center within two hours of their home, according to the U.N. Office for the Coordination of Humanitarian Affairs.

With travel restrictions imposed by the Taliban on women traveling more than 48 miles without a male guardian, women may feel even more discouraged from seeking care.

Negative Emotions Hit a Record High Among Afghan Women

Gallup has been tracking Afghans’ emotions since 2008. Worry, stress, anger and sadness soared to record levels among women and men in Afghanistan in 2021.

Like men, vast numbers of Afghan women reported feeling worried (85%), stressed (83%), sad (78%) and angry (62%) the day before the survey. However, women reported these emotions much more than men — particularly in regard to anger and sadness.

Record Numbers of Afghan Women Struggle to Afford the Basics

The Taliban’s takeover made Afghans’ ability to afford food even worse. By March 2022, an estimated 95% of Afghans did not have enough to eat.

Gallup surveys conducted before the Taliban regained control showed Afghans had been struggling for years to afford food — and women more so than men since 2017. At the time of the Hologic survey in 2021, a record-high 86% of women and 76% of men said there were times when they could not afford food that they or their families needed. Women also disproportionately struggled more than men to afford shelter.

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Implications, according to data from Hologic

In the 20 years after the fall of the Taliban in 2001, the Afghan government and international organizations made a concerted effort to prioritize the development of a national healthcare system. Despite mixed outcomes, there were some key wins, such as an increase in longevity from birth (by eight years for women from 2000 to 2019), improved access to healthcare, a decrease in maternal mortality, an increase of births supervised by specialists and more demand for family planning services.

Now, more than a year after the Taliban retook control of their country, Afghan women and girls have largely been erased from public life. More than ever, they are struggling to meet their basic needs, which may directly affect their ability to get the healthcare they need. Without healthy women, it will be impossible to rebuild or move forward — the economy is in free fall, with nearly half the country facing unprecedented levels of hunger.

Before the takeover, women’s access to care, while showing small signs of improvement in areas such as Kabul, was still below international standards. But now, across Afghanistan, women are unable to visit health clinics or have a doctor examine them without a mahram — a male chaperone.

If preventive care was rare in 2021 in Afghanistan, it is likely almost nonexistent in 2022, putting the lives of millions of Afghan women and girls at even greater risk, and making it even more important for their voices to be heard.

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