Strengthening Rural Healthcare: Comparative Innovations and Localized Strategies for Capacity Building
DOI:
https://doi.org/10.64229/nmjedn70Keywords:
Rural Healthcare, Capacity Building, Task-Shifting, Telemedicine, AfghanistanAbstract
Afghanistan’s rural healthcare system suffers from severe access limitations, workforce shortages, and inadequate infrastructure, undermining service delivery and population health. Innovative capacity-building models in comparable low-income settings have demonstrated the potential to overcome similar challenges.
Objective: To identify and adapt effective community health worker programs, task-shifting strategies, and telemedicine solutions from India, Rwanda, and Bangladesh for application in rural Afghanistan.
Methods: A mixed-methods design was employed, comprising a stratified survey of 400 healthcare workers and rural residents, 30 semi-structured interviews with key stakeholders, and secondary analysis of national health indicators to assess barriers and facilitators to implementation.
Results: Geographic isolation, gender disparities in the health workforce, and resource deficiencies were identified as primary obstacles. Eighty-five percent of stakeholders supported adapting task-shifting models, while 74% advocated for integrating telemedicine to extend reach into remote areas. Gender-inclusive recruitment and community engagement emerged as critical success factors for enhancing equity and service uptake.
Recommendations: Implement a gender-sensitive community health worker program and expand telemedicine infrastructure in underserved districts.
Establish standardized task-shifting protocols and supportive supervision mechanisms to ensure consistent, resilient service delivery.
References
[1]Davidson M, Kielar A, Tonseth RP, Seland K, Harvie S, Hanneman K. The landscape of rural and remote radiology in Canada: opportunities and challenges. Canadian Association of Radiologists Journal. 2024;75(2):304-12.
[2]Yar FGM. Rural Industries and Their Role in the Development of Rural Areas and Afghanistan's National Economy. Jurnal Indonesia Sosial Teknologi. 2024;5(10):4706-23.
[3]Sharma H, Singh SK. Socioeconomic inequalities in contraceptive use among female adolescents in south Asian countries: a decomposition analysis. BMC Women's Health. 2022;22(1):151.
[4]Nemat A, Asady A. The third wave of the COVID-19 in Afghanistan: an update on challenges and recommendations. Journal of Multidisciplinary Healthcare. 2021:2043-5.
[5]Yar FGM. Analysis of Challenges and Opportunities for Improving the Health System in Afghanistan: Innovative Approaches and Sustainable Solutions. Community Services: Sustainability Development. 2024;2(1):126-34.
[6]Bonfim D, Belotti L, de Almeida LY, Eshriqui I, Velasco SRM, Monteiro CN, et al. Challenges and strategies for conducting research in primary health care practice: an integrative review. BMC Health Services Research. 2023;23(1):1380.
[7]Yar FGM, Sail IU, Zahid S. Key Indicators in Analyzing the Sustainability of Afghanistan's Natural Resources. Formosa Journal of Multidisciplinary Research. 2024;3(10):3991-4008.
[8]Hadden K, Boagni M, Parham J, Patterson C, Gardner S. Design and Impact of a Novel Rural Hospital Alliance. Southern Medical Journal. 2024;117(2):67-71.
[9]Ndayambaje Rwagitare B. Cost effectiveness analysis of community health programs in Rwanda: a case study of Rusizi district: University of Rwanda; 2016.
[10]Pandey M, Misra S, Ray A, Rautaray S, editors. Roles and Impact of ASHA Workers in Combating COVID-19: Case Study Bhubaneswar. ICDSMLA 2021: Proceedings of the 3rd International Conference on Data Science, Machine Learning and Applications; 2023: Springer.
[11]Palozzi G, Schettini I, Chirico A. Enhancing the sustainable goal of access to healthcare: findings from a literature review on telemedicine employment in rural areas. Sustainability. 2020;12(8):3318.
[12]Frost A, Wilkinson M, Boyle P, Patel P, Sullivan R. An assessment of the barriers to accessing the Basic Package of Health Services (BPHS) in Afghanistan: was the BPHS a success? Globalization and health. 2016;12:1-11.
[13]Lamberti-Castronuovo A, Valente M, Bocchini F, Trentin M, Paschetto M, Bahdori GA, et al. Exploring barriers to access to care following the 2021 socio-political changes in Afghanistan: a qualitative study. Conflict and Health. 2024;18(1):36.
[14]Najafizada SAM, Bourgeault IL, Labonté R. A gender analysis of a national community health workers program: a case study of Afghanistan. Global Public Health. 2019;14(1):23-36.
[15]Oliveira R, Santinha G, Sá Marques T. The Impacts of Health Decentralization on Equity, Efficiency, and Effectiveness: A Scoping Review. Sustainability. 2023;16(1):386.
[16]Hossain N, Yokota F, Sultana N, Ahmed A. Factors influencing rural end-users' acceptance of e-health in developing countries: a study on portable health clinic in Bangladesh. Telemedicine and e-Health. 2019;25(3):221-9.
[17]Organization WH. Everybody's business--strengthening health systems to improve health outcomes: WHO's framework for action. 2007.
[18]Rogers EM, Singhal A, Quinlan MM. Diffusion of innovations. An integrated approach to communication theory and research: Routledge; 2014. p. 432-48.
[19]Yar, F. G. M. (2024a). Analysis of challenges and opportunities for improving the health system in Afghanistan: Innovative approaches and sustainable solutions. Community Services: Sustainability Development, 2(1), 126-134.
[20]Yar, F. G. M. (2024b). Rural industries and their role in the development of rural areas and Afghanistan’s national economy. Jurnal Indonesia Sosial Teknologi, 5(10), 4706-4723.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 fayaz Gul Mazloum Yar, Ezat Ullah Sail (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
