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Three decades of conflict have left Aghanistan with one of the highest maternal mortality ratios in the world as a result of neglected primary and maternal health services. While the government initiated the Basic Package of Health Services (BPHS) in 2003 to provide standardized basic health services, maternal health indicators have shown little improvement. Safe abortion is legally permitted only to save the life of the mother or if the child will be born with a disability. In 2017, the Afghanistan Ministry of Public Health (MoPH) introduced Post Abortion Care (PAC) Clinical Service Guidelines. International Medical Corps supported the Sharana Provincial Hospital in Paktika province, in partnership with the MoPH, from 2004 to 2018 to provide lifesaving emergency healthcare, including PAC services.

In July 2018, International Medical Corps, in collaboration with the Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative at Columbia University, conducted a mixed methods study to identify the factors that influence access to, use and provision of PAC services at Sharana Hospital. This technical brief provides background to the research, outlines the methodology, shares main findings, and notes key recommendations at the policy, systems, and community levels.


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