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Afghan Medical Staff Face Ongoing Security Threats: Study

TUESDAY, July 26 (HealthDay News) -- Despite dramatic improvements in Afghanistan's health services between 2004 and 2008, security issues for the country's health staff and patients remain a serious concern, researchers warn.

Investigators who examined health services at 25 facilities in 28 Afghan provinces over a five-year period found that health-care capacity and delivery of care had improved, but ongoing security threats are hindering progress and decreasing the likelihood that the country can emerge from its fragile status, according to the study published online July 26 in PLoS Medicine.

"These security issues threaten not just the evaluation of health-care provisionS, but the health-care services and providers themselves -- a complication virtually unknown in stable nations," the journal's editors stated in an editorial accompanying the study. "Within the last year, medical personnel have been attacked and killed in Afghanistan, even in the more peaceful areas within the country."

Health-care infrastructure and personnel are regular targets during combat, the editors pointed out in a journal news release.

In assessing the state of Afghanistan's health services, Anbrasi Edward, of the Johns Hopkins Bloomberg School of Public Health, and colleagues interviewed and observed 5,000 patients and interviewed 1,500 health-care providers. They also used a balanced scorecard to rate the following six areas: patient and community satisfaction with services; provider satisfaction; capacity for service provision; quality of services; overall vision for pro-poor and pro-female health services; and financial systems.

After tracking the country's progress over five years, by 2008 the study authors noted marked improvements in all six categories. They warned, however, that continued success in Afghanistan depends on how the country's leadership can adapt to changes in health systems policy.

"Despite the promising results so far, the successful execution of the [balanced scorecard] will depend on its adaptive ability and sustained efforts of the [Ministry of Public Health] leadership to accommodate dynamic and complex changes in the health-care environment," the researchers concluded.

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Doctors Without Borders has more about providing medical care in countries in crisis.

-- Mary Elizabeth Dallas

SOURCE: PLoS Medicine, news release, July 26, 2011

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