Due to its high importance and influence on families and society, family planning (FP) is one of the primary health care elements focused on by the Afghanistan Ministry of Public Health’s (MOPH’s) Reproductive Health Strategy (2012–2016). FP programs assist families to take appropriate reproductive decisions that suit their own circumstances to meet their needs and to achieve their reproductive health goals. The right to choose and hence control one’s own fertility is one of the most important reproductive rights of individuals. In addition, from a public health perspective, increasing access to FP information, services and supplies provides dramatic health benefits for women and children. It is also a cost-effective intervention that has an immediate impact on maternal mortality (decreased by 35%) and the health and economy of the country. When couples can choose the number, timing and spacing of their children, they are better able to adequately feed and educate their children, potentially ending the cycle of poverty.
Decades of conflict and political uncertainty in Afghanistan virtually ruined all sectors of the country, and Afghanistan’s health sector has widely suffered from the country’s unstable situation. Access to basic health care services and hospital services were almost
inconceivably limited. After the establishment of the transitional government in 2001, the MOPH decided to increase equitable distribution of health care services throughout the country. To achieve this, the MOPH introduced a comprehensive strategic package: the Basic Package of Health Services (BPHS). The main purpose of the BPHS is to provide a standardized package for delivering basic health care with a greater focus on reproductive and child health care services. Fortunately, introduction of this package has considerably increased coverage and accessibility. Later on in 2005, another package was introduced as complementary to BPHS: the Essential Package of Hospital Services (EPHS).
The MOPH made considerable achievements in terms of health care services distribution and coverage by implementing the BPHS and EPHS. For instance, to compare trends in maternal and child health coverage over time in Afghanistan, antenatal care coverage has been generally increasing since 2003, when it was 9%, while the most recent estimate for Afghanistan was 48.5%. In the same way, skilled birth attendance and institutional deliveries were both rising from 9.0% and 6.0% to 40.5% and 32.4%, respectively. Still, the level of contraceptive prevalence has remained very low, with only 13.8% of women using modern contraception in 2012. This has been the case despite the fact that FP services, including counseling and distribution of modern methods (condom, oral pills, injection, intrauterine devices and female sterilization), have been provided free of charge by most BPHS and EPHS health facilities (HFs) since 2003. At the same time, FP continues to be a priority for the MOPH, with objectives of gradually reducing the population growth rate, promoting the concept of a small family norm to the population in general and the rural population in particular, increasing the availability of and demand for FP services, increasing the quality of FP services, reducing unmet need, expanding and sustaining adequate FP services at the community level by utilizing all HFs, and encouraging the private sector and nongovernmental organizations (NGOs) to promote FP services. In light of these aims, the Reproductive Health Directorate (RHD) of the MOPH, through technical and financial assistance of the Helping Mothers and Children Thrive (HEMAYAT) project, initiated and conducted a national workshop for improving FP and birth spacing services in Afghanistan from 26–27 July 2015 at the Kabul Intercontinental Hotel.
