Five years after the Taliban returned to power, Afghanistan’s health system is being squeezed from two directions: shrinking healthcare services and restrictions that are making it increasingly difficult for women to reach them.

The consequences are particularly acute for Afghan women. Taliban-imposed restrictions on their movement, employment and education have narrowed access to healthcare, while the December 2024 ban on women training in health and medicine has prevented new female doctors, nurses and midwives.

UNICEF has warned that Afghanistan could lose up to 5,400 female healthcare workers by 2030 if restrictions on girls’ education and women’s employment continue. As many as 9,600 health workers could be lost by 2035, the agency said.

Multiple regions ban women from being treated by male medical professionals, and women are also banned from working in humanitarian agencies,

Maternity ward massacre

Zainab Mohammadi’s maternity experience spans two very different moments in Afghanistan’s recent healthcare history.

After seven years of trying to have a child, Mohammadi travelled from Bamiyan to Kabul in May 2020 and gave birth to a boy at the Médecins Sans Frontières (MSF) supported maternity wing of Dasht-e-Barchi hospital in west Kabul. She named him Omid, meaning “hope” in Dari. 

Gunmen stormed the maternity ward, killing 24 people, including 16 mothers, an MSF midwife and two children. MSF later said the maternity wing had been deliberately targeted, although it could not establish with certainty who carried out the attack or why.

Zainab survived, along with more than 100 people who escaped to safe rooms throughout the hospital. Her son Omid, less than half a day old, did not. “I had only four hours with my son,” she told Health Policy Watch.

MSF later said the massacre in the maternity wing had been deliberately targeted, although it could not establish with certainty who carried out the attack or why.

The assailants remain unidentified, and MSF withdrew from the maternity unit the following month, saying it could no longer put staff at risk of renewed attack. The 55-bed facility had provided free specialist maternity care and assisted almost 16,000 deliveries in 2019.

Violence to crisis

Six years later, Mohammadi’s second maternity experience illustrates a different threat to women’s healthcare: not an armed attack on a hospital, but a system in which distance, money, movement restrictions, lack of humanitarian funding and the availability of female health workers determine whether a woman receives care in time.

“Allah blessed me with a daughter last year,” Mohammadi said. “An elderly woman in our neighbourhood helped me a lot during the birth. But with many charity organisations gone and the Taliban’s restrictions on women’s freedom of movement, it has become extremely difficult for mothers like me to seek the care and support we need.”

For women like Mohammadi, the question is no longer simply whether a hospital exists. It is whether they can reach it, afford the journey and treatment, travel with a required mahram (male relative) and find an appropriately qualified female health worker when they arrive.

The attack came fifteen months before the Taliban swept back into Kabul. Six years later, Mohammadi’s second maternity experience reflects how the dangers facing Afghanistan’s women have evolved under their rule.

A system under financial pressure

Afghanistan’s health system was already fragile after decades of conflict, poverty and heavy dependence on international assistance. The funding crisis that intensified in 2025 has made that fragility more visible.

The World Health Organization (WHO) estimates that 14.4 million Afghans will require health assistance in 2026. Funding cuts are happening alongside food insecurity, disease outbreaks, climate shocks and large-scale returns from neighbouring countries.

Some 445 health facilities were suspended or closed during 2025, including 203 mobile health and nutrition teams, according to WHO data.

For remote communities, those mobile services were often the only practical connection to healthcare. Afghanistan’s maternal-health indicators have improved over the longer term, but the risks remain severe.

WHO and the Islamic Development Bank reported in May that the country’s maternal mortality ratio remains about 521 deaths per 100,000 live births. 

However, WHO says antenatal coverage has risen from 31% to 76% since 2007/08, while skilled birth attendance increased from 24% to 67%.

Health workers under pressure after ban on women

The ban on women training as health workers comes as the country faces a shortage of 115,000 health workers to meet WHO targets for key health workers per capita. Meanwhile, women already working in healthcare face restrictions on how and where they work.

Currently, 18% of specialised physicians and 29% of nurses are female.

Shafiqa Salarzai, a female health worker in southeastern Ghazni province, travels more than 10 kilometres each day to reach women affected by the earthquake in neighbouring Paktika, providing counselling to those who lost homes, husbands and children.

“We listen to those who are traumatised,” Salarzai told Health Policy Watch. “They’ve lost everything.”

But such services are often dependent on humanitarian funding and temporary arrangements. When funding ends, the healthcare option can disappear with it. The restrictions also affect female health workers themselves.

A February 2026 report by UN Special Rapporteur Richard Bennett found that restrictions on movement, gender segregation and “mahram” requirements had severely restricted women’s access to healthcare.

Bennett documented cases in which women were denied or delayed emergency treatment because they lacked a male guardian. In one case, a woman was left to give birth outside a hospital.

The addiction treatment gap

The crisis extends beyond maternal and primary healthcare. Hundreds of thousands of people affected by drug addiction are also caught in Afghanistan’s fragile health system.

When the Omid drug rehabilitation centre on the outskirts of Kabul was struck in an alleged Pakistani airstrike on 16 March this year, the immediate toll was measured in casualties. But for Afghanistan’s already limited addiction-treatment system, the more serious damage is only beginning to unfold.

“This was not just a strike on a building,” said Dr Abaseen Mohammadi, a Kabul-based addiction specialist who had referred patients to the facility. “It has taken out one of the very few places in the country where people could receive structured treatment. We have nothing in the public sector to replace it.”

Details of the strike remain contested. Afghanistan’s Taliban authorities say the facility was hit during Pakistani military operations, with significant civilian casualties, including patients undergoing treatment. Rights groups have called for the strike to be investigated as a possible war crime.

United Nations figures report more than 140 deaths, while investigations continue. Pakistan has acknowledged carrying out strikes in Afghanistan in recent months but denies targeting civilian or medical infrastructure.

The Omid centre played in the country’s treatment landscape. One of Afghanistan’s largest rehabilitation facilities, it reportedly housed up to 2,000 patients at a time and functioned as a central detoxification and intake hub. Its loss has exposed the scale of the treatment gap.

According to estimates from the United Nations Office on Drugs and Crime, between three million and four million people in Afghanistan are affected by substance use. Yet fewer than one in 10 have been able to access any form of structured treatment, leaving the vast majority without sustained care.

That gap has widened since 2021, when the collapse of the former Afghan government triggered a steep decline in international health funding. Much of the country’s healthcare system has been donor-financed, and cuts to development assistance have left services, including addiction treatment, struggling to operate at even minimal capacity.

“I took my brother there because we had no other solution,” Farid, a Kabul resident whose sibling was among those killed, told Health Policy Watch. “He had stopped using it for the first time in years. Now he is gone, and there is nowhere for others like him.”

Survivors describe a sudden loss of structure and support. Without follow-up care, many face a heightened risk of relapse in a context where community-based services are scarce, and stigma remains high.

“Substance use treatment is chronically underfunded, even where the need is enormous,” said an MSF regional officer. “When a facility like this is lost, there is no rapid replacement. The gap can persist for years.”

As Afghanistan enters the sixth year of Taliban rule, the country’s healthcare crisis is about more than the number of clinics that have closed or services that have been cut. It is also about who can reach those services, who can provide them and whether there will be enough trained health workers to sustain them.

The most consequential legacy of Taliban rule on the country’s health sector may therefore be not only what has already been lost, but the female healthcare workforce that is no longer being allowed to replace it.

Image Credits: WHO EMRO, MSF, CC, WHO, CC, Jacksoncam.