PDF(Pubmed)
Abstract：
BACKGROUND: The Taliban takeover in August 2021 ended a decades-long conflict in Afghanistan. Yet, along with improved security, there have been collateral changes, such as the exacerbation of the economic crisis and brain drain. Although these changes have altered the lives of Afghans in many ways, it is unclear whether they have affected access to care. This study aimed to analyse Afghans\' access to care and how this access has changed after August 2021.
METHODS: The study relied on the collaboration with the non-governmental organisation EMERGENCY, running a network of three hospitals and 41 First Aid Posts in 10 Afghan provinces. A 67-item questionnaire about access to care changes after August 2021 was developed and disseminated at EMERGENCY facilities. Ordinal logistic regression was used to evaluate whether access to care changes were associated with participants\' characteristics.
RESULTS: In total, 1807 valid responses were returned. Most respondents (54.34%) reported improved security when visiting healthcare facilities, while the ability to reach facilities has remained stable for the majority of them (50.28%). Care is less affordable for the majority of respondents (45.82%). Female respondents, those who are unmarried and not engaged, and patients in the Panjshir province were less likely to perceive improvements in access to care.
CONCLUSIONS: Findings outline which dimensions of access to care need resource allocation. The inability to pay for care is the most relevant barrier to access care after August 2021 and must therefore be prioritised. Women and people from the Panjshir province may require ad hoc interventions to improve their access to care.
METHODS: The study relied on the collaboration with the non-governmental organisation EMERGENCY, running a network of three hospitals and 41 First Aid Posts in 10 Afghan provinces. A 67-item questionnaire about access to care changes after August 2021 was developed and disseminated at EMERGENCY facilities. Ordinal logistic regression was used to evaluate whether access to care changes were associated with participants\' characteristics.
RESULTS: In total, 1807 valid responses were returned. Most respondents (54.34%) reported improved security when visiting healthcare facilities, while the ability to reach facilities has remained stable for the majority of them (50.28%). Care is less affordable for the majority of respondents (45.82%). Female respondents, those who are unmarried and not engaged, and patients in the Panjshir province were less likely to perceive improvements in access to care.
CONCLUSIONS: Findings outline which dimensions of access to care need resource allocation. The inability to pay for care is the most relevant barrier to access care after August 2021 and must therefore be prioritised. Women and people from the Panjshir province may require ad hoc interventions to improve their access to care.
摘要：
背景：塔利班于2021年8月接管了阿富汗长达数十年的冲突。然而，随着安全性的提高，有附带的变化，比如经济危机的加剧和人才外流。尽管这些变化在许多方面改变了阿富汗人的生活，目前尚不清楚他们是否影响了获得护理的机会。这项研究旨在分析阿富汗人获得护理的机会，以及这种机会在2021年8月之后如何变化。
方法：该研究依赖于与非政府组织EMERGENCY的合作，在10个阿富汗省份运行由3家医院和41个急救站组成的网络。制定了一份关于2021年8月后获得护理变更的67项问卷，并在紧急设施分发。序数逻辑回归用于评估获得护理变更是否与参与者特征相关。
结果：总计，返回了1807个有效的响应。大多数受访者（54.34％）表示，在访问医疗机构时安全性得到了提高。而其中大多数(50.28%)的设施到达能力保持稳定。大多数受访者（45.82％）的医疗费用较低。女性受访者，那些未婚而没有订婚的人，潘杰希尔省的患者不太可能感觉到获得护理的改善。
结论：研究结果概述了获得护理的哪些维度需要资源分配。无法支付护理费用是2021年8月之后获得护理的最相关障碍，因此必须优先考虑。妇女和来自潘杰希尔省的人可能需要临时干预措施，以改善她们获得护理的机会。
方法：该研究依赖于与非政府组织EMERGENCY的合作，在10个阿富汗省份运行由3家医院和41个急救站组成的网络。制定了一份关于2021年8月后获得护理变更的67项问卷，并在紧急设施分发。序数逻辑回归用于评估获得护理变更是否与参与者特征相关。
结果：总计，返回了1807个有效的响应。大多数受访者（54.34％）表示，在访问医疗机构时安全性得到了提高。而其中大多数(50.28%)的设施到达能力保持稳定。大多数受访者（45.82％）的医疗费用较低。女性受访者，那些未婚而没有订婚的人，潘杰希尔省的患者不太可能感觉到获得护理的改善。
结论：研究结果概述了获得护理的哪些维度需要资源分配。无法支付护理费用是2021年8月之后获得护理的最相关障碍，因此必须优先考虑。妇女和来自潘杰希尔省的人可能需要临时干预措施，以改善她们获得护理的机会。
