Last week marked five years since the Taliban stormed back to power in Afghanistan. The country’s women have seen their rights constricted from all sides – now, shrinking healthcare services and restrictions are making it difficult, sometimes impossible, for women to reach them.The past half decade of religious rule has seen women and girls barred from secondary and higher education, stripped of the right to leave their homes unaccompanied by men, or speak, sing, or read aloud in public.

December 2024 saw the Taliban close yet another door, forbidding women from engaging in medical and health education, leaving the country’s pipeline of future female doctors, nurses and midwives severely weakened.

The now guaranteed shortage of female health workers is compounded by restrictions on women being treated by male medical professionals, which is banned in multiple regions. Women are also banned from working in humanitarian agencies, raising the bar to access to care even higher.

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.

Afghan women often rely on female health professionals because of social expectations, gender segregation and restrictions on interactions between men and women. The presence of a female health worker makes it possible to speak openly about sensitive health problems – and can be the difference affecting whether many women seek care at all.

“With a male doctor, we cannot talk freely,” one woman receiving care from a female health worker in southeastern Ghazni province told Health Policy Watch. “With her, we can say everything.”

Maternity ward massacre

After seven years of trying to have a child, Zinab Mohammadi travelled 240 kilometres from her home city of Bamiyan to the capital, Kabul, in May 2020. There, she gave birth to a boy at the Medecins Sans Frontieres (MSF) supported maternity wing of Dasthe-e-Barchi hospital in the west of the city.

She named him Omid, meaning “hope” in Dari. Moments after she gave birth, masked gunmen stormed the maternity ward and opened fire. Twenty-four people, including 16 mothers, an MSF midwife and two children, were killed. One gave birth to a healthy child in the middle of the terror attack.

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, sayint 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

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.

Not an armed attack on a hospital, but the threats posed by a system in which distance, money, movement restrictions, a humanitarian funding crisis and dire shortage of female health workers stand in the way of women receiving 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 existence of equipped hospitals – while still scarce –  is no longer the only challenge. 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 workers when they arrive.

Already fragile system crumbles

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, making Afghanistan one of the most dangerous countries on earth to give birth, with one woman dying every hour.

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

Maintaining those gains depends on a functioning health workforce. With the complete ban on women in the pipeline – currently 18% of specialised physicians and 29% of nurses are female – that workforce is under enormous pressure.

The slashing of female 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.

Shafiqa Salarzai, a female health workers 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

Omid, the name Mohammadi gave her son, was also the name of one of the few places in Afghanistan where hope came in institutional form for the hundreds of thousands of people caught in the country’s addiction crisis.

The facility – one of the largest rehabilitation centres in the country housing up to 2,000 patients at a time – is a vital cog in Afghanistan’s fragile rehabilitation care system, functioning as a central detoxification and intake hub. The Pakistani Army’s attack devastated patients and doctors, exposing a widening care gap in a country where three to four million people are affected by substance use disorders and just one in 10 are able to access any form of structured treatment.

“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.”

While details of the strike remain contested, what is less disputed is the critical role the Omid centre played in the country’s treatment landscape. Survivors and relatives 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.

“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 for the first time in years. Now he is gone, and there is nowhere for others like him.”

The care gap laid bare by the strike on Omid 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.

“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 health crisis appears as an increasingly consequential legacy of their government – closed clinics, humanitarian organisations in retreat, services cut.

Yet the erasure of Afghanistan’s female health workforce of the future, and severe restrictions and women’s access to what remains of the country’s hospitals and clinics, may be the most lasting health legacy of all.

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