Availability and quality of emergency obstetric and neonatal care services in Afghanistan

Young Mi Kim, Partamin Zainullah, Jaime Mungia, Hannah Tappis, Linda Bartlett, Nabila Zaka

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objective: To assess the availability and utilization of emergency obstetric and neonatal care (EmONC) facilities in Afghanistan, as defined by UN indicators. Methods: In a cross-sectional study of 78 first-line referral facilities located in secure areas of Afghanistan, EmONC service delivery was evaluated by using Averting Maternal Deaths and Disabilities (AMDD) Program assessment tools. Results: Forty-two percent of peripheral facilities did not perform all 9 signal functions required of comprehensive EmONC facilities. The study facilities delivered 17% of all neonates expected in their target populations and treated 20% of women expected to experience direct complications. The population-based rate of cesarean delivery was 1%. Most maternal deaths (96%) were due to direct causes. The direct and indirect obstetric case fatality rates were 0.8% and 0.2%, respectively. Conclusion: Notable progress has been made in Afghanistan over the past 8 years in improving the quality, coverage, and utilization of EmONC services, but gaps remain. Re-examination of the criteria for selecting and positioning EmONC facilities is recommended, as is the provision of high-quality, essential maternal and neonatal health services at all levels of the healthcare system, linked by appropriate communication and functional referral systems.

Original languageEnglish (US)
Pages (from-to)192-196
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Issue number3
StatePublished - Mar 2012
Externally publishedYes


  • Afghanistan
  • Delivery (obstetric/standards)
  • Emergency obstetric and neonatal care
  • Health services availability
  • Maternal health
  • Neonatal health

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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