This brief was prepared by UNFPA Asia-Pacific Regional Office, in collaboration with UNFPA Afghanistan Country Office, outlining the country context, challenges and opportunities that lie in eliminating Obstetric Fistula in the country.

Country Context

Afghanistan is facing an ongoing humanitarian crisis, with political instability, rapid economic decline and three years of consecutive drought driving food insecurity and unprecedented levels of hunger. A staggering 28.3 million people - two thirds of the population - need urgent humanitarian assistance in order to survive. The crisis is also reversing gains that have been made over the last 20 years, including around the rights of women and girls.

Millions of people in Afghanistan have little or no access to health care, and the country remains one of the most dangerous places in the world to give birth. One woman dies every two hours during pregnancy or childbirth from causes that would largely be preventable with access to skilled care. The estimated 20,000 women who give birth each month in hard-to-reach areas of the country face particular challenges reaching hospitals or health facilities.

Before the crisis, Afghanistan had made significant progress in improving life expectancy and reducing mortality since 2000. Life expectancy increased from 45 years in 2000 to 61 years in 2012. These improvements were largely achieved through implementing a Basic Package of Health Services (BPHS) and an Essential Package of Hospital Services (EPHS). By 2017, all secondary and tertiary health facilities had midwives; 90% of primary facilities had midwives; 66% of the population lived within one hour's travelling time to a health facility; 88% of the population lived within two hours' travelling time; and health posts with male and female community health workers had been established in more than 15,000 communities.