“I did not see her face. I could not see her face. They told me my baby daughter was born still – without life. They told me I should have paid more attention, that I should have been more careful. 

But how could I? We have no clinic nearby, and the nearest health professional is several hours away. My sister-in-law said I should have consulted a doctor before. But going to the clinic and coming back costs so much money. With the ongoing crises, even daily food is a challenge. How were we to spare money for transportation?” 

-Kubra (20) 
*not her real name 

One woman dies in Afghanistan every two hours while trying to give birth.  

167 children die in Afghanistan from preventable causes every day. 

According to the UN, “Afghanistan remains one of the most dangerous places in the world to be a baby, a child, or a mother, and access to a hospital or health facility is beyond the reach of most”. The maternal mortality ratio stands at a staggering 620 per 100,000 live births; which is the highest in Asia and among the 10 worst across the world. This alarming statistic isn't just a number; it's a reflection of the daily struggles faced by Afghan women, worsened by socio-political turmoil, economic instability, healthcare inadequacies, and stringent restrictions on women's rights. 

Being a pregnant woman in Afghanistan was already a challenge and the situation is not improving.  The public healthcare system in Afghanistan has been underfunded and overburdened for years. With support from international funding, commendable progress was made in ensuring access to life-saving healthcare for women and young girls between 2001 to 2021. However, since 2021, there has been a significant shrink in foreign donor funds putting the country’s health system on the brink of collapse and undoing all the progress made over the past two decades. 

Why is Afghanistan One of the Most Dangerous Places to Give Birth? Here are the key factors putting Afghan mothers at risk: 

Socio-political instability and economic hardship 
The socio-political landscape of Afghanistan, marked by decades of conflict, has profoundly impacted the nation's healthcare system. Economic turmoil, fueled by political instability and international sanctions, has exacerbated healthcare challenges, leading to severe shortages in medications and supplies, and causing a critical drain of healthcare professionals. This instability has disrupted the delivery of essential health services, leaving many Afghans, especially in rural and remote areas, without access to the care they need. 

Increase in child marriage and underage pregnancy
The economic collapse and humanitarian crisis in Afghanistan have led to a marked increase in child marriage and underage pregnancy, profoundly impacting the lives of young girls across the nation. To combat chronic poverty, mounting debt, and food insecurity, families have resorted to marrying off their daughters at even younger ages. UNICEF has reported credible accounts of families offering daughters as young as 20 days old for future marriage in return for a dowry, underscoring the severity of the situation. 

The closure of schools for teenage girls has further emphasised this issue, increasing the risk of child marriage. Education, often seen as a key protection against such practices, remains inaccessible for 80% of school-aged girls and young women in the country. This lack of educational opportunity leaves young girls vulnerable to early marriage, domestic violence, and complications related to early pregnancies. The intertwining factors of poverty, lack of education, and cultural pressures create a cycle of disadvantage that continues to affect generations of Afghan women. 

Knowledge gap at the community level
Individuals and families in many communities around Afghanistan lack critical knowledge about pregnancy care, failing to recognise early risk factors or seek timely medical intervention. This widespread lack of understanding extends to optimal nutrition during pregnancy, leading to malnutrition-induced complications and exacerbating the maternal health crisis. 

Educational constraints, particularly for women and girls significantly limit access to information that could improve maternal health outcomes. With an increasing number of Afghan girls married before the age of 18 and many becoming mothers shortly after that, the cycle of malnutrition and ill health perpetuates. Young mothers, often unaware of or unable to implement essential nutritional and prenatal care recommendations, face increased risks. The lack of education and awareness within communities continues to undermine efforts to improve maternal health, highlighting the urgent need for comprehensive community-based health education and support. 

Cultural barriers 

"Why would a woman need to go to the hospital?" 31-year-old Zia Gul, a resident of the northern Parwan Province, recalled her husband saying during her difficult pregnancies. "There are only men at the hospital; there are no female doctors" .

This quote exemplifies the severe cultural barriers that Afghan women face in accessing healthcare. Despite life-threatening risks, women lack the autonomy to decide whether to seek medical support. Rather, these critical decisions are controlled by male family members. 

Fragile healthcare system
The Afghan healthcare system is critically under-resourced, overstretched, and struggles to meet the needs of its population. This challenge is exacerbated by a stark deficit in the health human resource to population ratio; there are only 0.3 doctors for every 1,000 individuals, (the World Health Organisation (WHO) recommends a minimum of 1 doctor for every 1000 individuals), illustrating a dire shortage of healthcare professionals. According to WHO, Afghanistan has one of the lowest healthcare worker densities, significantly below the threshold considered adequate to maintain essential health services. The lack of medical supplies and skilled healthcare workers has been further aggravated by the economic crisis, leaving the system in a precarious state. With international aid dwindling, the healthcare infrastructure faces severe limitations in providing essential services, including maternal and child healthcare. This shortage of trained, community-based healthcare professionals not only affects the delivery of immediate care, but also undermines the capacity for long-term health planning and response to public health emergencies. 

In Afghanistan’s remote landscapes, a staggering 80% of women give birth at home, often with only an elder's guidance, if not facing the challenge alone. This is double the national average, showcasing a profound disparity in healthcare access, particularly for women and young girls. While many international aid agencies withdrew their support from Afghanistan after the regime shift, some national and international NGOs and UN agencies have remained active, striving to make motherhood safer amid the ongoing instabilities. However, more than two years into the regime change, Afghan girls are more vulnerable than ever and require urgent support. One woman dies in Afghanistan every two hours while trying to give birth. With coordinated efforts from donor agencies, the UN, NGOs, and CSOs, these deaths can be prevented and lives can be saved. 

A global plea: stand with Afghanistan’s women 

In 2025, while humanity reaches new frontiers in technology and innovation, Afghan women are fighting for something far more fundamental—the right to survive. Since 2021, drastic cuts in international aid have pushed Afghanistan’s fragile healthcare system to the brink of collapse, leaving mothers and children without access to even the most basic medical care. This is not just a setback; it’s a humanitarian disaster unfolding in real time. The world cannot look away. Now, more than ever, donor agencies and international organisations must step up—not just with short-term relief — but with sustained investments to rebuild Afghanistan’s healthcare system. Every moment of inaction costs lives. 

—-- 

The author is Regional Lead - Asia at Global Resource Mobilization and Partnerships, BRAC International. 

LinkedIn: Tanjila Mazumder Drishti 

Instagram: tanjiladrishti

X / Twitter: @TanjilaDrishti

Disclaimer 

The views expressed in this opinion piece are those of the author/s and do not necessarily reflect the views or policies of IDS.