Is there a shortage of female health workers in (MOPH) Paktya province Afganistan? : a descriptive case study design

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Human resources development for health is a crucial part of the any health system. Afghanistan has the second highest MMR and high IMR in the world. According to World Bank 2006, report gender development index is the lowest in the world. Conflict had devastating consequences on the overall health system but the health workforce was most seriously affected. Afghanistan is among those countries, which have critical shortage of human resources for health. These health workforce problems in the country, especially the issues related to female health workers, lead to the proposal of this study. The first objective of this study was to determine accurately the numbers and proportion of female health workers (FHW3) in Basic Package of Health Services (BPHS). The second objective was to explore perceived reason for shortage of three categories of female health workers including medical doctors, nurses and midwives. This is an exploratory descriptive case study, conducted in Paktya province of Afghanistan. The whole province with its 14 health facilities was the subject of the case study. Mixed methods are used for data collection. Employment records were reviewed and FGD and key informant interviews were conducted. Two FGD were conducted in Gardez city. Two key informant interviews were also conducted, one at the provincial level and the other at national level. The qualitative component of the data were collected trough data extract sheet and qualitative component by key informant interview and FGD. Appropriate guideline was prepared for both methods at local languages. The study of the administrative records revealed that a total of 232 health personnel in the health facilities of Paktya BPHS. The study determined that there is critical shortage of health workers. The rate of doctors in Paktya province was found to be 0.07 per 1000 population, nurse is 0.065 and midwives are 0.05 per 1000 population. These rate are lower than national level that is 0.2 for doctors and 0.5 for nurses and midwives. These rates are also lower then levels of health care personnel recommended by WHO. The study also explored the reason for shortage. The reasons included problems with infrastructural development factors, sociocultural factors, family system, governance/political, economic, and gender bias. In summary, the study has demonstrated a critical shortage in the human resources shortage. This account, shortfalls of health workforce will lead to great loss of efficiency, equity and productivity. The rapidly changing health system in Afghanistan has many gaps of knowledge and intervention. Further research studies should explore the effect of socio-cultural factors, family system and the role of gender bias on health workforce. The planning of the health workforce should be made strengthen at the national and provincial level with support of health and non-health policies. Most emphasis should do on the curriculum of medical colleges and institute of health sciences for correctness of the imbalances. The entrance of women should be encouraged to reach the national strategy of reducing maternal mortality ratio (MMk) and a level to achieve the health millennium development goals (MDGs).

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