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Kabul: Difference between revisions
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'''OVERVIEW''' | [[File:Mountains of Kabul.jpg|400px | thumb|right|]] | ||
'''OVERVIEW''' | |||
'''''NOTE:''''' In August 2021, Taliban forces retook Kabul<ref>https://www.msn.com/en-us/news/world/who-are-the-taliban-and-how-did-they-take-over-afghanistan-so-swiftly/ar-AANmUse</ref>, and it was reported that the Taliban told all working women to stay at home.<ref>https://www.bbc.com/news/world-asia-58315413?utm_source=nextdraft&utm_medium=email</ref> All information on sexual and reproductive health care in the country is subject to change. The information in the article written below was from before the change in government. We will add updates to this page when we have more details. | |||
==Contraception (Birth Control)== | ==Contraception (Birth Control)== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Afghanistan, oral contraceptives (birth control pills) are technically available over-the-counter (i.e. no prescription required).<ref>[http://ocsotc.org/wp-content/uploads/worldmap/worldmap.html Global Oral Contraception Availability]</ref><ref>[http://freethepill.org/where-on-earth/ Free the Pill: World Map]</ref> However, the reality is that birth control pills can be hard to find. According to one local contributor: "There is almost no access for local women to contraceptives other than condoms. It is possible to get a prescription for combined oral contraceptive pills, but the quality is not comparable to the assortment of pills in Western countries. There are NGOs in the country providing contraceptives of all kinds in Afghanistan, but not all local women have access to these NGOs." You can visit the bottom of this page ("Additional Resources") for a list of NGOs to contact. | |||
Generally speaking, Afghanistan has a high fertility rate and maternal mortality rate. Nearly one in ten Afghan women give birth as an adolescent, and the country's fertility rate is five children per woman, according to 2014 data. Furthermore, nearly 18% of all deaths of women of childbearing age are due to pregnancy-related causes. These high numbers can be attributed to many factors, including lack of sex education and general education, lack of contraceptive access, and inadequate skills or training among health care staff.<ref>[https://www.unfpa.org/news/acceptance-family-planning-grows-afghanistan-myths-linger Acceptance of family planning grows in Afghanistan, but myths linger]</ref> | |||
According to a 2015 UN report, it was found that about 29% of Afghan women (who are of reproductive age and married/in unions) use some form of contraception, including traditional methods, and about 27% of women have unmet family planning needs. This rate is much lower than the average rate of contraceptive use in Southern Asia, where about 57% of women use contraceptives, or Western Asia, where about 58% of women use contraceptives. In Afghanistan, the most commonly used birth control method is contraceptive injectables, which are used by about 12% of Afghan women, and birth control pills, which are used by almost 7% of women. There are very low rates of usage for all other forms of contraceptives, including traditional methods (3.8%), condoms (1.6%), IUDs (1.5%), withdrawal (1.5%), contraceptive implants (1%) and female sterilization (0.7%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref> | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* [https://www.mariestopes.org/where-we-work/afghanistan/# Marie Stopes Afghanistan]: "Currently, we operate 11 centres across five provinces, through which all-female staff offer a comprehensive range of services, including contraception and post-abortion care. We also work with public health sector staff, delivering services through eight public hospitals." Looking for services in Afghanistan? Use the contacts below to speak with our advisers. Call centre: +93 075 2220 000 or 075 2025 900 / Psycho-social call centre: +93 0799 67 87 77 | |||
* There is a reported problem of counterfeit drugs, which may be dangerous or ineffective.<ref>[https://beamexchange.org/practice/snapshots/abif-afghanistan-pharmacies/ ABIF: Providing the right prescription for Afghanistan's pharmacies]</ref> For this reason, it is recommended that you try to visit pharmacies that are more widely trusted. One example is 768 Pharmacy<ref>[https://www.ft.com/content/f8b4e5d2-1c1e-11e5-8201-cbdb03d71480 InFrontier takes stake in Afghan pharmacy chain]</ref>, which is a pharmacy chain in Afghanistan with multiple locations. You can also visit pharmacies at hospitals, such as the [http://www.americanmedicalaf.com/ American Medical Center]. | |||
===Costs=== | ===Costs=== | ||
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==Emergency Contraception (Morning After Pill)== | ==Emergency Contraception (Morning After Pill)== | ||
'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here]. | '''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here]. | ||
===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Afghanistan, no emergency contraceptive pills are registered for usage. However, it is reportedly legal to import emergency contraceptive pills through licensing. While there are no emergency contraceptive pills procured through the government, they may be available through certain NGOs or programs affiliated with the International Planned Parenthood Foundation.<ref>[https://www.cecinfo.org/country-by-country-information/status-availability-database/countries/afghanistan/ EC Status and Availability - Afghanistan]</ref> | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
In Kabul are several international clinics and hospitals mainly treating expats and providing | * It may be difficult to access dedicated emergency contraceptive pills (ECPs) in Afghanistan. However, you can try to use regular oral contraceptives (birth control pills) as replacement ECPs. To do this, you can take Stediril-d (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later).<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref> For updated information on how to use birth control pills as replacement ECPs in Afghanistan, please visit the [http://ec.princeton.edu/ Princeton EC Website]. | ||
There is no such service accessible for local women. | * From one local: "In Kabul, there are several international clinics and hospitals, mainly treating expats and providing Western contraceptives, such as the morning after pill. There is no such service accessible for local women." (October 2017) | ||
===Costs=== | ===Costs=== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In 2018, it was found that 7200 children and adults were living with HIV in Afghanistan, which was less than 0.1% of the population. A large percentage of Afghan people with HIV are not receiving treatment; it was found that only about 13% of children and adults with HIV were receiving anti-retroviral therapy in 2018.<ref>[https://www.unaids.org/en/regionscountries/countries/afghanistan UNAIDS: Country factsheets AFGHANISTAN 2018]</ref> | |||
===Testing Facilities=== | |||
===Support=== | |||
===Costs=== | ===Costs=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
Most upper middle-class Afghan women tend to get a visa to either [[Pakistan]] or [[India]] to get their gynecological treatment, as they do not trust the Afghan medical facilities and doctors. | |||
===Costs=== | ===Costs=== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Afghanistan, abortion is not available upon request. However, it is legally permitted to save the life of the pregnant person.<ref>[http://worldabortionlaws.com/map/ World Abortion Laws]</ref> <ref>[https://www.womenonwaves.org/en/page/4830/afghanistan--abortion-law Afghanistan: Abortion Law]</ref> To learn more, you can read the Afghan [https://abortion-policies.srhr.org/documents/countries/01-Afghanistan-Penal-Code-1976.pdf Penal Code] for details. | |||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* "Misoprostol is on the list of National essential medicines list of Afghanistan. However misoprostol availability and brandname are unknown. Please go to www.womenonweb.org to obtain abortion pills." - Women on Waves<ref>[https://www.womenonwaves.org/en/page/5499/afghanistan--organizations-and-clinics Afghanistan: Organizations and Clinics]</ref> | |||
* [https://www.jhpiego.org/ Jhpiego]: E-mail: info@jhpiego.org | |||
* [https://www.mariestopes.org/where-we-work/afghanistan/# Marie Stopes Afghanistan]: "Currently, we operate 11 centres across five provinces, through which all-female staff offer a comprehensive range of services, including contraception and post-abortion care. We also work with public health sector staff, delivering services through eight public hospitals." Looking for services in Afghanistan? Use the contacts below to speak with our advisers. Call centre: +93 075 2220 000 or 075 2025 900 / Psycho-social call centre: +93 0799 67 87 77 | |||
===Costs=== | ===Costs=== | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* Police: Call 102 | |||
* Ambulance: Call 103 | |||
* [https://womenforafghanwomen.org/womens-protection-centers/ Women's Protection Centers]: "Recognizing that women and girls who seek our Family Guidance Center services are often escaping life-threatening and dangerous situations at home, WAW created Women’s Protection Centers (WPCs) (also known as women’s shelters) to provide confidential, safe shelter to protect endangered clients until their cases are resolved. WAW’s WPCs provide women and girls whose lives have been threatened or who have suffered violence and abuse with safe haven and support services while they are under WAW’s protective care. The goal of WAW’s WPC is to improve the overall well-being and future life outcomes of women and girls who are survivors of human rights abuses or gender-based violence." Since 2007, WAW has successfully built 12 WPCs in 11 provinces, directly transforming the lives of thousands of women and girls in Afghanistan. Afghanistan Office: Noor Mohammad Taraki Street, Police District #3, Kabul, Afghanistan, Tel: +(93) 728-859-560 | |||
* [http://www.hawca.org/new/index.php/projects/ongoing-projects/174-safe-house-for-women Women Protection center, Kabul]: "The women protection center provides all the necessities of life including health, educational and sport facilities. Empowering women legally and economically is another objective of the project. Due to the successful implementation of this project in 2015, HAWCA provided protection services to 199 women and 71children. Out of these cases, 105 were resolved through court and mediation. The remaining cases are followed in 2016." | |||
* [http://www.hawca.org/new/index.php/projects/ongoing-projects/170-legal-aid-centers-for-women-victims-of-violence Legal Aid centers for Women Victims of Violence Mazar]: "he legal aid center in Mazar is one of our centers that help women victims of violence." They provide legal, medical, literacy, training, and advocacy services. | |||
* [http://www.hawca.org/new/ Humanitarian Assistance for the Women and Children of Afghanistan (HAWCA)]: "Humanitarian Assistance for the Women and Children of Afghanistan (HAWCA) was established in January 1999 by a group of youth Afghan women and men. HAWCA's establishment was motivated by the despair and devastation suffered by Afghan women and children as victims of war and injustice in Afghanistan and as refugees in Pakistan. Living under the same conditions and experiencing the same misery as millions of Afghans in Afghanistan and in Pakistan during the civil war, the leading members of HAWCA committed to achieving their aims and objectives as volunteers, and devoted their efforts to improving the lives of Afghans under difficult circumstances, from the era of Taliban domination to today's insecure Afghanistan." | |||
===Costs=== | ===Costs=== | ||
==List of Additional Resources== | ==List of Additional Resources== | ||
* [http://moph.gov.af/en Ministry of Health] | |||
* [http://www.afga.org.af/ Afghan Family Guidance Association]: "Afghan Family Guidance Association (AFGA) is an Afghan non-governmental, not-for-profit and non-political organization established in 1968. AFGA has been working in the field of Reproductive health and Rights since its inception and has recently become an associate member of International Planned Parenthood Federation (IPPF). AFGA activities were suspended due to war and conflict in the country for ten years (1992-2002) and resumed its activities in 2002 with financial support from International Planned Parenthood Federation (IPPF). IPPF is an alliance of 151 family planning associations known as Member Associations which has projects in over 180 countries. IPPF continues to be the largest civil society provider of reproductive health information and services in the world." | |||
* [https://www.familyplanning2020.org/afghanistan Family Planning 2020 - Afghanistan]: "Afghanistan has finalized its Reproductive, Maternal, Newborn, Child, and Adolescent (RMNCAH) strategy as well as the Costed Implementation Plan (2018-2022) for family planning. Afghanistan has made strides since making its first FP2020 commitment in 2016 by increasing the number of public health facilities offering family planning and expanding contraceptive choice..." | |||
* [https://internationalmedicalcorps.org/country/afghanistan/ International Medical Corps Afghanistan] | |||
* [https://www.doctorswithoutborders.org/what-we-do/countries/afghanistan Doctors without Borders Afghanistan] | |||
* [https://www.care.org/country/afghanistan CARE Afghanistan] | |||
* [http://ahead.org.af/ AHEAD Afghanistan]: "AHEAD was established by a group of experienced, professional and dedicated social workers in Afghanistan in 2008, and was registered under license number 1259 with the Ministry of Economy of the government of the Islamic Republic of Afghanistan." | |||
* Click [http://www.equaldex.com/region/afghanistan here] to learn about LGBT-related laws in Afghanistan. Be aware that homosexuality is illegal. | |||
==References== | ==References== | ||