Afghanistan: Can condoms fulfill multiple expectations?

KABUL, 6 May 2008 (IRIN) - Millions of condoms will be distributed across Afghanistan in 2008 in a new drive to prevent sexually transmitted diseases, reduce maternal mortality and improve family planning, aid agencies and the Ministry of Public Health (MoPH) said.

Millions of condoms have been purchased and imported into Afghanistan by international aid organisations and will be offered either free or at an affordable price (around 2 US cents) to Afghan couples through thousands of health facilities, private pharmacies and general stores.

The MoPH said it had received about three million condoms from donor organisations, including the UN Population Fund (UNFPA), all of which will be distributed for free in 2008.

Marie Stopes International (MSI), a UK-based organisation dealing with family planning, said it would offer 2.5 million condoms at subsidised prices in local markets.

"The attitude of many Afghans is changing," Farhad Javid, the MSI programme director in Kabul, told IRIN. "And condom usage has been increasing," he said, adding that there was still a need to boost public awareness in order to increase condom demand.

"We are promoting condom usage to achieve a number of public health targets," said Abdullah Fahim, a spokesman of the MoPH.

Several positive points

The condom has found its way into conservative Afghanistan over the past six years. The number of users has risen sharply in urban areas, say officials. During Taliban rule, and indeed before that, the subject of condoms and sex was widely considered taboo and rarely discussed in public.

"There are several positive points about a condom; it controls sexually transmitted diseases such as HIV/AIDS, it can be used as a contraceptive, and it is safe," said Fahim.

The exact number of Afghans living with HIV/AIDS is unknown, but MoPH estimates at least 3,000 people might have been infected by the virus. Most are undiagnosed and lack adequate awareness about the risks of HIV/AIDS.

Health specialists said Afghanistan could have an effective HIV/AIDS control policy if it effectively promoted the use of condoms.

Reducing maternal mortality

According to the UN Children's Fund (UNICEF), at least two women die every hour in Afghanistan due to obstetric-and-pregnancy-related complications – 1,600 deaths per 100,000 live births – which places the war-torn country second to Sierra Leone in terms of its maternal mortality rate.

Lack of access to health services, malnourishment, early marriages and multiple pregnancies are the main reasons for Afghanistan's high maternal mortality rate, according to MoPH.

"If we ensure at least a two-year gap between pregnancies we will definitely reduce maternal mortality," Hamida Ebadi, director of the Safe Motherhood Department in the MoPH, told IRIN, adding that condoms could be an "effective" and "reliable" contraceptive.

"It's also in line with Islamic principles that a mother should have a gap between pregnancies," she said.

In addition to condoms, the MoPH and aid agencies provide other contraceptives, including pills, injections and intrauterine devices, in order to prevent unplanned pregnancies and mitigate health risks.

Condoms are also considered a very important tool for family planning and population growth control, Javid of MSI said. The average Afghan woman has 7-8 pregnancies (a fertility rate of 7.11) and most females marry before the age of 18, aid agencies estimate.

"Should the current 3.5 percent annual population growth rate continue Afghanistan will have over 65 million people by 2050," Javid said.  

Source: Integrated Regional Information Networks (IRIN), a project the Office for the Coordination of Humanitarian Affairs. IRIN is UN humanitarian news and information service, but may not necessarily reflect the views of the United Nations or its agencies.

[This report does not necessarily reflect the views of the United Nations]