Date of Award

12-2020

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Zafar Fatmi

Second Advisor

Dr. Courtland Robinson

Third Advisor

Dr. Uzma Khan

Department

Community Health Sciences

Abstract

Background: Wars and conflicts identified as the leading cause of death and DALY among reproductive age in Afghanistan. The country has experienced almost three decades of civil war and is currently in the 20th year of war against terrorism. The health system in Afghanistan has been affected adversely besides all other infrastructures. This study was aimed to assess the pattern of war-related injuries and to identify the strength and weaknesses in the hospital and rehabilitative care of these injuries in Kabul, Afghanistan.
Methodology: Mix method exploratory design has been used to achieve the objectives of this study. The study was conducted from August 2020 to October 2020 in 5 major centers in Kabul, Afghanistan. The selection of the centers for this study was purposive based on the inclusion criteria of being a center which provides care for war related victims. The hospitals included in this study were all public. Since the public sectors provide the bigger part of care for these victims. However, for the rehabilitation services, two major centers in Kabul (one public and one NGO related) were included. The study participants were the key informants in the Ministry of Public Health, service managers, service providers such as doctors, nurses, physiotherapists, technicians, and service users. The purposive sampling followed by snowball sampling technique was used for the selection of these participant. The data collection was done in two phases: first, record review, where the hard copy of 265 war-related injured were reviewed, and the qualitative data collection where the in-depth interviews were conducted with the key informants. The first phase assessed the war injury patterns, and the second part captured the strength and weaknesses in the hospital and rehabilitation services.
Findings: Males (80.4%) were more prone to injuries than females (19.6%). More than half (55.5%) of the injured victims were in the age group of (20-39) year-old, followed by the victims in the age group of < 19. More than half (58.1%) of the affected people were married, and unemployed (79.2). Active battle gunshots were the main cause of war injury (37.7%), followed by suicide bombings VII (34.3%). Incidentally, lower extremities were the most affected site by this type of injury. Moreover, the findings from the qualitative data show the availability of a control and command center for emergency responses including war emergencies. However, areas such as human resources, services, infrastructures, and health management information systems need major improvement.

Conclusion: Gunshot injury majority in males were the main cause of injury due to war. Moreover, despite some mini strengths available in the hospital care of victims, the absence of an integrated and complex trauma system, lack of training opportunities for the health care providers, and gaps in health management information systems was obvious.

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1

Last Page

73

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