Women's health and human rights in Afghanistan.

CONTEXT

During the past 20 years, social and political upheavals have disrupted the way of life in Afghanistan. The Taliban regime, a radical Islamic movement that took control of Kabul in September 1996, has had extraordinary health consequences for Afghan women.

OBJECTIVE

To assess the health and human rights concerns and conditions of women living in Kabul under the Taliban regime.

SETTING

Residences in Kabul; refugee camps and residences in Pakistan.

DESIGN

A cross-sectional survey of women who lived in Kabul, prior to September 1996, when the Taliban took control.

PARTICIPANTS

A total of 160 women participated, including 80 women currently living in Kabul and 80 Afghan women who had recently migrated to Pakistan.

MAIN OUTCOME MEASURES

Self-reported changes in physical and mental health, access to health care, war-related trauma, human rights abuses, and attitudes toward women's human rights.

RESULTS

The median age of respondents was 32 years (range, 17-70 years); median formal education was 12 years, and 136 (85%) of respondents had lived in Kabul for at least 19 years. Sixty-two percent (99/180) reported that they were employed before the Taliban takeover; only 32 (20%) were employed during their last year in Kabul. The majority of all women reported a decline in physical and mental health status (71% [113/160] and 81% [129/160], respectively) and reported a decline in access to health care (62% [99/160]) during the last 2 years living in Kabul. Many of the women reported symptoms that met diagnostic criteria for posttraumatic stress disorder (42% [67/160]), demonstrated evidence of major depression (97% [155/160]), and had significant anxiety symptoms (86% [137/160]). Eighty-four percent (134/160) of women reported 1 family member or more killed in war. Sixty-nine percent (111/160) reported that they or a family member had been detained and abused by Taliban militia, and 68% (108/160) reported extremely restricted social activities. Almost all (96%) expressed support for women's human rights.

CONCLUSIONS

The current health and human rights status of women described in this report suggests that the combined effects of war-related trauma and human rights abuses by Taliban officials have had a profound effect on Afghan women's health. Moreover, support for women's human rights by Afghan women suggests that Taliban policies regarding women are incommensurate with the interests, needs, and health of Afghan women.