International Rescue Committee, 3 Bloomsbury Place, London, WC1A 2QL UK.
Jhpiego/Afghanistan, an affiliate of Johns Hopkins University, Shar-e-Naw, Street 3, House 265, Kabul, Afghanistan.
Confl Health. 2015 Mar 16;9:9. doi: 10.1186/s13031-015-0037-6. eCollection 2015.
For over a decade, Afghanistan's Ministry of Public Health and its international development partners have invested in strengthening the national health workforce and establishing a system of primary health care facilities and hospitals to reduce the high levels of maternal and child mortality that were documented shortly after the fall of the Taliban in 2001. Significant progress has been made, but many challenges remain. The objective of this study is to assess the availability and distribution of human resources for round-the-clock comprehensive emergency obstetric and newborn care service provision in secure areas of Afghanistan in order to inform policy and program planning.
A cross-sectional assessment was conducted from December 2009 to February 2010 at the 78 accessible facilities designated to provide emergency obstetric and newborn care in Afghanistan. The availability of staff on call 24 hours a day, seven days a week; involvement of staff in essential clinical functions; turnover rates; and vacancies were documented at each facility. Descriptive statistics were used to summarize results.
All facilities assessed had at least one midwife on staff, but most did not meet the minimum staffing requirements set in national guidelines. Given that all facilities assessed are considered referral centers for lower-level clinics, the lack of doctors at 5% of facilities, lack of anesthetists at 10% of facilities and lack of obstetrician/gynecologists at 51% of facilities raises serious concerns about the capacity of the health system to respond with lifesaving care for women with obstetric complications.
While the government continues its efforts to increase the number of qualified female health professionals in Afghanistan after decades with little female education, innovative strategies are needed to facilitate deployment, skill-development and retention of female healthcare providers in underserved areas.
十多年来，阿富汗公共卫生部及其国际发展伙伴一直致力于加强国家卫生人力队伍建设，并建立初级卫生保健设施和医院系统，以降低 2001 年塔利班倒台后记录的高孕产妇和儿童死亡率。已经取得了重大进展，但仍存在许多挑战。本研究的目的是评估安全地区提供 24 小时全面急诊产科和新生儿护理服务的人力资源的供应和分布情况，以为政策和规划提供信息。
2009 年 12 月至 2010 年 2 月，对阿富汗 78 个指定提供紧急产科和新生儿护理的可进入设施进行了横断面评估。记录了每个设施的 24 小时值班人员的可用性、工作人员参与基本临床职能的情况、人员更替率和空缺情况。使用描述性统计数据对结果进行了总结。
所有评估的设施都至少有一名助产士，但大多数都不符合国家指南规定的最低人员配置要求。鉴于所有评估的设施都被视为下级诊所的转诊中心，5%的设施缺乏医生，10%的设施缺乏麻醉师，51%的设施缺乏妇产科医生，这对卫生系统提供救生护理的能力提出了严重关切。
在阿富汗几十年几乎没有女性接受教育的情况下，政府继续努力增加合格的女性卫生专业人员数量，需要创新战略来促进在服务不足地区部署、发展和保留女性医疗保健提供者的技能。
