Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Public Health and Community Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt.
Front Public Health. 2024 Sep 24;12:1370500. doi: 10.3389/fpubh.2024.1370500. eCollection 2024.
In Afghanistan, providing universal health coverage (UHC) in accordance with the principles of the UHC declaration is challenging on two fronts: the geographic topography of the country and the prevailing gender dynamics within the local culture.
We conducted a desk review of underserved areas in the context of health services by gathering and analyzing existing literature, reports, and data using a combination of keywords and phrases such as: "underserved areas," "healthcare disparities," "access to healthcare," and "health services." The primary data were derived from an analysis of underserved populations conducted by the World Health Organization (WHO) Afghanistan's Emergency Program, supplemented by information from in-country partners. In addition to other reports, this review focused on analyzing the geographical availability of primary healthcare (PHC) services by employing the guidelines set forth in the SPHERE framework. It also took into account the social dynamics within the Afghan population that may create barriers to equity in terms of demand and access to PHC services.
Although there are a significant number of primary healthcare facilities in operation (4,242), they are unevenly distributed across different regions of Afghanistan, resulting in almost 25% of the population being underserved. The underserved population is nearly equally distributed between genders, with the majority residing in rural communities. Women of childbearing age represent 28% of the underserved population. Children under the age of five represent 16-18% of the underserved population in all regions, except in the western region, where they represent between 12 and 13%. Individuals over 60 years of age represent 1-3% of the underserved population across all regions. More than 50% of the population in the Central Highlands of Afghanistan is underserved, followed by the western and southern regions. Ghor province in the western region has the highest proportion of underserved populations, followed by Zabul province in the southern region.
Afghanistan is currently experiencing a protracted humanitarian crisis, with millions of people living in poverty and lacking access to healthcare. This situation exposes them to serious risks such as disease epidemics, starvation, and maternal and child mortality. It is crucial to implement alternative strategies to reach the most affected populations and to increase funding for the delivery of healthcare services in Afghanistan.
在阿富汗，按照全民健康覆盖宣言的原则提供全民健康覆盖面临着两个方面的挑战：该国的地理地形和当地文化中普遍存在的性别动态。
我们通过收集和分析现有文献、报告和数据，使用“服务不足地区”、“医疗保健差距”、“获得医疗保健”和“医疗服务”等关键词和短语，结合关键字和短语对卫生服务方面的服务不足地区进行了桌面审查。主要数据来自世界卫生组织（世卫组织）阿富汗应急方案对服务不足人群的分析，辅之以国内合作伙伴的信息。除其他报告外，本审查还侧重于根据 SPHERE 框架中的准则分析初级医疗保健（PHC）服务的地理提供情况，并考虑到阿富汗人口中的社会动态，这些动态可能会对 PHC 服务的需求和获得造成公平障碍。
尽管有相当数量的初级保健设施在运作（4242 个），但它们在阿富汗不同地区的分布不均，导致近 25%的人口得不到服务。服务不足的人口在性别上几乎平均分布，大多数人居住在农村社区。育龄妇女占服务不足人口的 28%。所有地区五岁以下儿童占服务不足人口的 16-18%，除西部地区外，该地区占 12-13%。60 岁以上的人占所有地区服务不足人口的 1-3%。阿富汗中部高地的人口中有一半以上得不到服务，其次是西部地区和南部地区。西部戈尔省的服务不足人口比例最高，其次是南部的扎布尔省。
阿富汗目前正经历一场旷日持久的人道主义危机，数以百万计的人生活在贫困之中，无法获得医疗保健。这种情况使他们面临严重的风险，如疾病流行、饥饿、孕产妇和儿童死亡率上升。必须实施替代战略，以覆盖最受影响的人群，并增加对阿富汗提供医疗服务的资金。
