Afghanistan: Insecurity and health care costs put patients at risk | Doctors Without Borders

Eighty-one percent of respondents said they had experienced financial difficulties as a result of spending on health care, such as needing to borrow money or reduce spending on food or other essential needs.

Large parts of the population in Afghanistan do not have access to a functioning medical facility near their homes to obtain quality, free medical care. The distances patients have to travel, the dangers of armed conflict, and the costs of medical care remain the most difficult barriers, in a context of pervasive poverty.

A third of those surveyed by MSF identified violence and insecurity on the roads as a key obstacle. Patients and caretakers say they must weigh the possibility of mined roads, ground fighting, checkpoints, and criminality—before seeking care.

At the same time, underfunded and underresourced health care facilities are unable to deliver basic services, the report found.

International donors—whose decisions have shaped the current model of health care financing and delivery in Afghanistan—have announced considerable reductions in future funding assistance for the country, and some linked assistance to politically motivated conditions. This will increase the pressure on the fragile public health system and on health partners to meet the rapidly growing medical needs of the Afghan population.

“Rather than cutting resources, international donors and health care providers should urgently review the challenges facing Afghanistan’s patients and health system, in order to reduce barriers to health care,” Noko said.

MSF is a medical humanitarian organization operating under the principles of independence, impartiality, and neutrality. Since the 1980s, MSF has provided medical care throughout Afghanistan, in areas under the control of a variety of political and armed factions. Currently, MSF works in Helmand, Herat, Kandahar, Khost, and Kunduz provinces. In Afghanistan, MSF relies solely on private funding and does not accept funds from any government for its work.