Barriers to seeking post-abortion care in Paktika Province, Afghanistan

Unsafe abortion is a leading cause of maternal mortality. In Afghanistan, which has experienced decades of armed conflict and where abortion is highly restricted, maternal mortality is high at 638 maternal deaths per 100,000 live births. Post-abortion care (PAC) is a lifesaving package of interventions to reduce morbidity and mortality related to induced or spontaneous abortion. Yet, it is rarely provided and often of poor quality, particularly in humanitarian settings. This study sought to identify the factors that influence access to and use of PAC services at Sharana Provincial Hospital.

In interviews and focus group discussions, PAC clients and community participants discussed similar barriers to seeking PAC. These include cost, distance to the health facility, the need for male accompaniment to seek care, perceived and actual quality of care, stigma and shame. Despite the mentioned stigma around abortion, community members expressed willingness to help women to receive PAC.

While some barriers are not unique to PAC, others, especially those related to stigma around abortion, may be specific to PAC. It is important for the Ministry of Public Health and its partners to prioritize addressing these barriers to ensure that women have access to this critical life-saving care.