Achieving the Millennium Development Goals of Reducing Child Mortality and Improving Maternal Health remains a significant challenge in Afghanistan. Decades of conflict, human displacement, years of drought and ongoing economic and political fragility have resulted in extremely poor health conditions, some of the worst in the world, for the over 29 million citizens of Afghanistan. There is a high prevalence of chronic malnutrition and widespread micronutrient deficiencies, compounded by the environmental stresses of drought. Moreover, the skilled human resources needed to respond to the range and complexities of health challenges are grossly inadequate. Functioning health facilities are few, widely dispersed and poorly equipped while health promotion programs and the infrastructure needed to prevent illness (e.g. water and sanitation systems) remain minimally developed.

The current geographical disparities in health status across the country reflect differences in health knowledge and behaviors within and across communities as well as the absence of good quality health care services. In remote areas of Afghanistan such as Badakhshan, a range of factors limits a woman’s ability to have a safe pregnancy and delivery. These include: living in isolated and inaccessible rural areas; high levels of illiteracy; inadequate and inaccurate health care knowledge leading to poor birth-preparedness practices; and, limited mobility outside the home due to lack or cost of transportation, and cultural restrictions. Human resources in health are limited due to the outmigration of health and allied health professionals, low salaries, and a lack of continuing medical training and standardized medical education programs. A survey by the World Health Organization (WHO) concluded that 70 percent of nurses, midwives, and laboratory technicians in Afghanistan did not have the minimum knowledge and skills to meet basic standards. Further exacerbating the situation is the cultural practice that prevents women from being treated by male health workers, especially in the technical areas of obstetrics and gynecology.

Average life expectancy

• The Women's Low Life Expectancy in Afghanistan has improved.  In 2006, the life expectancy for Afghan men was 43.4 years and for women 43.3 years, and in 2012, it is estimated to be 48.45 years for men and 51.05 for women;
• The main reason of women's low life expectancy in Afghanistan is the high number of women who die in connection with pregnancy and childbirth;
  

Maternal Mortality Rate

• The single biggest killer of adolescent girls is pregnancy, according to the United Nations Population Fund (UNFPA), with the youngest first-time mothers bearing the highest risks of maternal morbidity and mortality;
• In Afghanistan, as the education level and wealth increase for women, fewer give birth before the ages of 15 to 19;
• One in four women aged 20-24 years have already had a live birth before reaching age 18;
• Afghanistan was known for having had the highest Maternal Mortality Rate (MMR) in the world. While this has changed over the past decade, with a much higher number of women able to access skilled birth attendants, there remains much that must be done to give more Afghan women a better chance at surviving childbirth, and enjoying safe motherhood;
• In 2010, MMR was 460 deaths per 100,000 childbirths. A significant change from 2002, where MMR was estimated at 1,600 per 100,000 childbirths (during that time the figure was 2000 times higher than in Norway);
• By 2011, only 48% of women receive care at least once by a skilled health personnel during the pregnancy, while in 2003, only 14% of births were attended by skilled birth attendants; and
• Health authorities in Afghanistan have targeted to reduce childbirth mortality even further.  However, Reducing MMR in Afghanistan is a challenge of mammoth proportions as most births, especially in rural areas, happen at home without qualified medical assistance.

Infant Mortality Rate and Under-5 Years Mortality Rate

• Infant mortality Rate  (IMR) in Afghanistan is one of the highest in the world;
• In 2011 IMR was estimated to be 74 per 1000 live births.  A decrease of almost 50% from 2003;
• IMR is 62 per 1000 births for the wealthiest households, and 75 for the poorest;
• IMR for mothers with no education is 74, while it is notably 55 for mothers with secondary education or higher;
• The government target is to reduce the IMR to 70 by 2015 and further down to 46 by 2020;
• Afghanistan’s Under-5 Years Mortality Rate (U5MR) is still one of the highest child mortality rates in the world, with more than 1 in 10 children dying before their fifth birthdays;
• U5MR is at 102 per 1000 live births in 2011.  In fact, here has been a laudable progress with a reduction of more than one third over that 20-year period (230 per 1000 live birth that was registered in 2003);
• The Afghan government wants to reduce U5MR by 50 % by 2015; and
• MDGs 4 aims to reduce IMR and U5MR by two thirds between 1990 and 2015.

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Sources:

• Afghanistan's Ministry of Public Health: Vision for Health 2005-2015 – retrieved September 2012
• Afghanistan Mortality Survey 2012 - APHI
  
• Afghanistan Multiple Indicator Cluster Survey (AMICS) 2010-2011 – June 2012
• World Bank Indicators 2012
• WHO (World Health Statistics) 2008