Afghanistan
Report
Summary
Cost is the Biggest Limiting Factor to
Healthcare Access Non-communicable diseases (NCDs) represent the
world’s leading cause of death and collectively kill 18
million women each year. As part of the “Insights from
10,000 Women on the Impact of NCDs” survey
conducted by Arogya World, 1,015 women in urban
areas of Afghanistan were surveyed by face-to-face
interviews from March 15-19, 2014.
Nearly half of women surveyed (49%) say someone
in their household suffers from an NCD – heart
disease, diabetes, cancer, or chronic lung disease.
43% of women have had to provide care for a
household member suffering from NCDs.
Even though half of Afghani women do not work
for pay, 13% of the women surveyed had to
withdraw from the labor force in order to care for a
household member with NCDs.
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60% NCDs Affect Everyday Lives
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How do you pay for your healthcare most of the time? Prevalence and Burden of NCDs
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Over half of Afghani women (53%) pay the doctor
out of pocket and 11% of women reported having to
borrow money from friends or family to cover the
out of pocket expenses.
Out of pocket payments were significantly higher
than the global average.
Only a third of women were able to get access to
healthcare through government healthcare, free
clinics, or private or employer health insurance.
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53 50% 39 40% 32 31 30% 21 20% 11 10% 4 0% 0 Government Private or Pay doctor directly Borrow money healthcare or free employer health (out of pocket) from friends or clinics insurance family Afghanistan NCD Testing is Severely Lacking
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Most Women Have Regular Health Exams
Most women (64%) were examined by a medical
professional in the last year, but 14% of women have
not seen a healthcare professional in the last 2 years.
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But Have Not Been Adequately Tested for NCDs
2 Other Global Half of women report that caring for family
members with NCDs presents a financial burden,
with a quarter of women indicating that more than
25% of household income is spent on NCDs. 6% of
women said that NCD treatment consumes more
than half of household income.
Almost 60% of Afghani women stated that not
having enough money is the major obstacle to seeing
a healthcare professional, compared to 34% of
women globally reporting the same concern.
Long waiting time (43% of women) was also a
significant factor in limiting healthcare access.
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The percentage of women who have received a given
NCD tests lags 7-14% behind the global norm.1
Just 15% of women have ever received a cervical
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cancer screening test.
Merely 1 in 5 women have had a breast exam by a
medical professional.
In the past year, which of the following reasons prevented you Less than half of women have received a blood sugar
from going to the doctor or other medical professionals? 70% test and only 57% have had a blood pressure test.
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Have you ever had any of the following medical tests?
80% 57 60% 20% 29 15 20 60% 58 50% 63 43 40% 40% 50 30% 27 13 0 0% Cervical Cancer Breast Exam by Blood Pressure Blood Sugar Screening Test a Medical Test Test Professional Afghanistan Global None of the above 1
7 The global norm is represented by the 10-country aggregate from Arogya’s
“Insights from 10,000 Women on the Impact of NCDs” survey.
20% 43 34 30 27 14 11 5 10% 0% 28 25 0 I did not have Health facility I did not have Waiting times enough money was too far transportation were too long away Afghanistan Global None of the above 0 Other Health Concerns of Afghani Women
In a typical week, do you engage in the following activities at least 2 days a week for at least 10 minutes each day? Women are Concerned About Smoking • Only 8% of women in Afghanistan smoke,
80% compared to 26% globally.
However, the most concerning issue for Afghani
women regarding their household health is smoking
or second-hand smoke (30%). This percentage is
double the global norm.
80% of women are concerned about children seeing
advertisements for cigarettes and tobacco products
on TV, billboards, and other public places. 2
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Thinking about your household, which health issue are you most concerned about? 30 22 13 13 16 0% 26 20% 7 19 50% 40% 60% Smoking or second-‐hand smoke Drinking too much alcohol 2 Unhealthy diet 30% 80% Only 8% of women report exercising regularly.
While 84% of women report participating in
strenuous household chores at least two days a week
for 10 minutes at a time, only 40% walk, 14%
exercise, and 2% ride a bicycle.
The percentage of women walking, exercising, and
riding a bicycle were strikingly less than the global
average from our survey.
A quarter of women said that the reason they did
not exercise was because it was not culturally
acceptable. Not having enough time was also a
barrier.
A fifth of women were most concerned about being
overweight and 13% were most concerned about not
getting enough exercise.
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What is your main challenge to exercising regularly? 40% 34 35% 30% 25 24 25% 20% 15 17 24 19 12 15% 10% 8 8 7 5% 0% Afghanistan 5 Physically Exercising is Other reason/
unable not culturally No answer acceptable Global 2
0 Option for “drinking too much alcohol” was not asked in Afghanistan. 5 0% Exercise or play sports Walk Ride a bicycle Do strenuous None of the household above chores Afghanistan Global Women Eat Healthy Foods But Cost is a Barrier
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More Afghani women report eating healthy foods
(83%) than the global norm (72%).
A remarkably high 7 in 10 women stated that they
do not eat any food from restaurants, street food, or
take out food on a weekly basis, giving women more
control over healthy eating practices.
But 60% of Afghani women stated that healthy
foods are prohibitively expensive.
Women also agreed that healthy foods spoil quickly
(36%) and are difficult to cook (30%).
In a typical week, how many times do you eat food not prepared in your home, such as food from restaurants, street food, or take out food? Afghanistan 70 Global 25 30 0% Never 52 20% 40% 1 -‐ 2 times a week 4 1 11 60% 3 -‐ 4 times a week 80% 6 100% 5 or more times a week Thinking about healthy foods (such as fruit and vegetables, low-‐fat foods), which statements do you agree with? 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 83 72 59 39 36 30 30 14 0 Healthy foods Healthy foods Healthy foods I eat healthy are too spoil quickly are too hard to foods expensive prepare/cook 1 1 Not Not Not enough No place to applicable—I interested or time exercise do exercise motivated regularly 15 2 10% 100% Exercise is Limited Due to Cultural Practices
40 14 20% 14 Being overweight Not getting enough exercise None of the above 36 40% 22 18 59 60% •
Global 66 70% •
Afghanistan 84 90% Afghanistan 4 None of the above Global For additional information about the “Insights from 10,000
Women on the Impact of NCDs” survey, go to
http://arogyaworld.org/programs/capturing-the-voices-of10000-women/report/.