Healthcare access in humanitarian settings: Mobile services successes and limits in Afghanistan

Abstract

With an ever-increasing number of humanitarian emergencies being declared around the globe, identifying effective methods to provide healthcare access to affected communities is all the more relevant to health practitioners. Mobile health services have been widely implemented by international and national actors to reach underserved communities in humanitarian contexts. Nonetheless, little rigorous evidence exists on the effects of such services. Our work contributes to filling the knowledge gap by studying the role of mobile health teams (MHTs) in Afghanistan after the institution of the Taliban De Facto Authority in 2021. We conduct correlational and quasi-experimental analysis of country-wide survey data and matched with geo-localised information on MHTs and their related service delivery points (SDPs) - at least in part of the country - from WHO and UNICEF. Our findings show mobile services enhance recent access to health care by about 11 percentage points (about 14% over comparison) based on our preferred model. We also identify a decreasing effect of number of MHTs and SDPs on healthcare access. Our results indicate that higher number of mobile services do not necessarily translate to better access, although strong differences exist between underserved and better served areas within the country.

Keywords: Afghanistan; Healthcare access; Humanitarian; Impact; Mobile health services.