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ObjectivesThis study aimed to investigate the prevalence and associated factors of anaemia and its association with the academic performance of schoolchildren in Kandahar, Afghanistan.DesignThis was a cross-sectional analytical study.Setting and participantsThis was a school-based study conducted among 1866 schoolchildren aged 6–14 years in Kandahar city from September to December 2023. Haemoglobin concentration was measured using a portable HemoCue Hb 301 analyser, while the WHO age-adjusted cut-off for haemoglobin was used to classify anaemia. Data were analysed by using descriptive statistics, the χ² test and multivariate logistic regression.ResultsIn this study, the mean age of the children was 9.1 years, 61.1% (1138/1866) were boys, 83.6% (1560/1866) had illiterate mothers, and 81.3% (1517/1866) belonged to poor families. Prevalence of anaemia among schoolchildren was 64.1% (1196/1866), while 20.8% (388/1866), 41.7% (778/1866), and 1.6% (30/1866) were suffering from mild, moderate and severe anaemia, respectively. Main associated factors of anaemia were being male (adjusted OR (AOR) 1.4, 95% CI 1.1 to 1.7, p=0.003), unemployed father (AOR 1.5, 95% CI 1.1 to 2.2, p=0.020), poor family (AOR 2.3, 95% CI 1.8 to 2.9, p<0.001), large family (AOR 1.2, 95% CI 1.0 to 1.6, p=0.048), history of intestinal helminths (AOR 1.3, 95% CI 1.0 to 1.6, p=0.017) and decreased meat consumption (AOR 2.0, 95% CI 1.6 to 2.5, p<0.001). Children with anaemia had significantly lower academic performance.ConclusionsPrevalence of anaemia was very high and is a severe public health problem in schoolchildren of Kandahar. Based on the known consequences of anaemia on academic performance, the education and health authorities of Afghanistan should take serious steps to alleviate this problem. Periodic iron supplementation and deworming, as well as daily iron-rich mid-day meal programmes, should be started for both boys and girls in schools.

Background Equitable access to healthcare depends not only on the overall availability of medical professionals but also on their fair geographic distribution. Physicians are central to patient care and health system development. This study aimed to assess the physician-to-population ratio and analyze the geographic distribution of physicians across Afghanistan, highlighting existing disparities. Methods This cross-sectional study uses data from a comprehensive national health workforce assessment in Afghanistan conducted in 2023 by WHO and KIT Royal Tropical Institute. The parent study utilized a multi-stage census-style count followed by facility-level verification across health facilities in the public and private sectors. For this analysis, physician data was extracted and analyzed disaggregated by province, specialization, sector, and gender. Geographic inequities in physician distribution were assessed using Gini coefficients and Lorenz curves for all 34 provinces. Results In 2023, Afghanistan had 13,155 active physicians, including 8,099 general practitioners (GPs) and 5,056 specialists. This corresponds to 3.93 physicians per 10,000 population—2.42 GPs and 1.51 specialists per 10,000 people. The overall shortage is exacerbated by unequal geographic distribution, as reflected by a Gini coefficient of 0.357 representing provincial physician-to-population ratios, indicating moderate inequality. Kabul has 9.31 physicians compared to Badakhshan 1.04 per 10,000 population. Conclusion Afghanistan faces a substantial shortage of physicians, compounded by significant gender disparities and pronounced geographic inequities. Addressing these gaps is critical for improving equitable access to healthcare services.

Vaccine hesitancy is defined as \"delay in acceptance or refusal of vaccination despite the availability of vaccination services\". The low acceptance rate of covid-19 vaccination, reported in many countries, is a big challenge in efforts toward putting end to the pandemic. In this study, we aim to find the acceptance and hesitancy rates toward Covid-19 vaccine along with its reasons among medical students in Kabul. In this cross-sectional study that was conducted among medical students of five randomly selected universities in Kabul, a total of 459 medical students completed the questionnaire. The hesitancy rate for covid-19 vaccine among medical students was 42.3%, hesitancy rate in males was more than in female students. The essential reason for refusing of the vaccine was concerns about safety and adverse effect of the vaccine (62.3%). More than half of the participants (51.5%) have already been vaccinated. In 60.2% of participants, protection against the COVID-19 virus was the main reason for accepting the vaccine. This study indicates that social media was the leading source (64.3%) of information about vaccine hesitancy. This study indicates a high level of hesitancy toward the COVID-19 vaccine among medical students. It is strongly advised to deliver accurate information on the safety and effectiveness of COVID-19 vaccines to the community especially, medical students.

To evaluate the occurrence, extent, and severity of adverse reactions associated with the vaccine of COVID-19 (ChAdOx1 nCoV-19 vaccine or AstraZeneca) among Kabul University of Medical Sciences staff. A retrospective observational, interview-based study was conducted from 4 to 20 April, 2021, to evaluate the adverse reactions associated with the vaccine of COVID-19 (ChAdOx1 nCoV-19 vaccine or AstraZeneca) among the staff and lecturers of the Kabul University of Medical Sciences, Kabul, Afghanistan. Participants were interviewed following the administration of the first dose of the AstraZeneca vaccines. They were asked to report any adverse reactions that occurred within 8-10 days after vaccination. The frequency, duration, severity, and outcome of the reactions were recorded. Association of the adverse reactions was analysed with the ages of participants and previous infection with SARS CoV-2. The most common adverse reactions reported by the participants were muscle pain (68.3%), local pain (58.8%) at the site of injection (68.3%), fever (66.3%) and fatigue (66.3%). Almost half of the respondents reported chills, joint pain and headache after receiving the first shot of the vaccine. The frequency of adverse reactions was higher in participants aged 40 years or less, and in those previously infected with SARS CoV-2. The severity of most adverse reactions was mild to moderate. No serious case or death was reported. The adverse reactions reported by the participants were mild to moderate in severity, and for a short duration. The findings of this study help us to address the vaccine hesitancy caused by worries about severe adverse effects associated with the COVID-19 vaccine.

BackgroundSince 2021, Afghanistan has faced a worsening humanitarian crisis that disproportionately impacts Afghan women and children. They experience inequities in healthcare access, deterioration of healthcare quality and extreme food insecurity. This study aims to fill an important gap by providing consensus on research priorities for maternal, newborn and child health (MNCH), sexual and reproductive health (SRH) and nutrition in Afghanistan.MethodsThe Child Health and Nutrition Research Initiative (CHNRI) is a widely used research prioritisation methodology that crowdsources input from subject matter experts to generate, score and rank research questions. This study reached out to 303 Afghanistan health researchers, who were identified through relevant publications, to align on the 20 highest priority MNCH, SRH and nutrition research questions. Question generation occurred in 2022, and data collection and analysis were completed by January 2025.ResultsThe CHNRI exercise had 81 respondents, of which 53% were of Afghan origin. The 20 highest priority research questions for MNCH, SRH and nutrition in Afghanistan were mostly description and delivery questions in MNCH and nutrition topic areas. The top questions ranged from characterising the availability, access and quality of MNCH services, to leveraging locally available interventions for malnutrition and food security, to strategies for increasing immunisation coverage.ConclusionBy identifying high-priority research questions, donors, researchers, implementers and governments can align their research agendas and resource allocation to address critical health challenges for women and children in Afghanistan.

IntroductionAfghanistan’s health system has faced considerable challenges since the Taliban takeover in 2021, leaving the population vulnerable to an increased risk of morbidity and mortality. Research to illuminate the current functioning of the health system and approaches for strengthening its key components is critically needed to address imminent and evolving health needs of the Afghan people.MethodsA health systems’ research agenda for Afghanistan that uses a systematic and evidence-based wisdom of the crowds’ approach has yet to be developed. Using the Child Health and Nutrition Research Initiative methodology, this study identifies the top 20 health systems’ research priorities among experienced Afghanistan health researchers. Priorities were also considered when disaggregating data by subgroups, such as Afghan versus non-Afghan respondents and those from low- and middle-income versus high-income settings.ResultsA total of 303 researchers were invited to score the research questions; 86 responded to the scoring survey and 55 completed it (60% were of Afghan origin). The highest priority questions were relatively diverse in terms of topic area, with questions spanning system-level factors, healthcare quality, community-based healthcare, improvements in the pharmaceutical sector, epidemiological trends, health management information systems and surveillance, access to care and approaches to improving service delivery in Afghanistan, among many others. ‘Delivery’-focused and ‘development’-focused questions were prioritised, demonstrating that participants assigned greater importance to more practical research questions that would explore features of and approaches to improving existing health system structures within the current Afghan context. Results were consistent across subgroups.ConclusionThis research prioritisation exercise fills a gap by generating consensus and establishing a research agenda for strengthening Afghanistan’s health system.

This study was conducted to evaluate the prevalence of symptoms of anxiety among residents of Kabul during the present COVID-19 pandemic. This descriptive cross-sectional, community based survey was conducted in Kabul, Afghanistan, during the COVID-19 pandemic. Data were collected from July 11, 2020, to July 16, 2020. A bilingual (Dari and English) questionnaire was used for data collection. The first section of the questionnaire collected sociodemographic information of the respondents and the second comprised a self-report standardized scale, i.e. Generalized Anxiety Disorder-7 (GAD-7) to assess symptoms of anxiety. The survey form was distributed through online platforms. All residents of Kabul who used social apps such as WhatsApp and Facebook were eligible to participate in the study and participation was voluntary and non-commercial. Altogether 1135 complete responses were received. The majority of them were males and aged 18-34 years. Almost 18% were healthcare workers. Overall, 28.2% of the respondents reported symptoms of moderate to severe anxiety, 38.8% reported symptoms of mild anxiety, and nearly one third of the respondents reported no symptoms. Female participants reported significantly higher levels of anxiety compared with males (39.7% versus 25.6%; p = 0.0001). No significant association was noted between anxiety levels and age groups, occupations, and healthcare workers versus non-healthcare workers. The findings suggest that a gender-specific psychosocial protocol needs be integrated into the public health emergency plans to fight against the current pandemic.