A gendered approach to improving the quality of antenatal care, postnatal care, and family planning services in Afghanistan

This study evaluated the effects of using a gendered approach to improving the quality of antenatal care, postnatal care, and family planning services in Afghanistan. Women, mostly Muslim, who are seeking reproductive health services are more likely to seek care from health facilities if a female provider is available. As part of a quality assurance approach, the HSSP Project trained service providers on gender awareness. They were encouraged to provide more gender sensitive services. For that purpose, the project provided specific standards. The project also supported pre-service training to midwives and placed in facilities across the five provinces.

This study used data from 23 health facilities in 5 provinces in Afghanistan. As part of the project's quality assurance approach, the health facilities were assessed using standard criteria. The quality of antenatal services (from 10% to 100% at the BHC level, from 25% to 78% at the CHC level, and from 0% to 89% at the DH level), postnatal services (from 25% to 91% at the BHC level, from 9% to 82% at the CHC level, and from 17% to 68% at the DH level), and family planning services (from 23% to 76% at the BHC level, from 28% to 81% at the CHC level, and from 17% to 66% at the DH level) has improved since the implementation of a standardized quality assurance method that included a gender approach.

Gender sensitive services seem to be critically important in Afghanistan not only for increasing service access, but also for improving quality of services to women. The introduction of standards, training, supervision, and problem solving interventions, coupled with placement of qualified female midwives at service facilities can improve quality of reproductive health services.