HEALTH SEEKING BEHAVIORS IN BPHS UNCOVERED AREAS OF MEHTERLAM, ALISHANG, ALINGAR AND QARGAYEE DISTRICTS OF LAGHMAN PROVINCE, AFGHANISTAN.

Rational: The BPHS 2010 is claiming that almost 85% of population is covered and have access to health services in all over the country. It has been also claiming by MOPH that the vicinities which they are located in 2-3 hours walking distance from health facilities have access and benefited from BPHS health facilities. Community is not agreed and stated that they are not benefited from health services in such distance that several reasons are claimed. To understand the reality a house holds survey was conducted in rural villages of 4 districts (Mehteralm, Qarghayee, Alingar and Alishang) of Laghman province. Objectives of the study: Primary objectives of the study is to understand the health seeking behaviors in BPHS uncovered areas. Where the secondary objectives of the study are:  To identify health gaps in BPHS uncovered areas  To provide recommendation for solution of the existing problems  To lead the action for health status improvement in the areas.  To provide a baseline data and set the targets for provision of the services  To provide base for evaluating the effect of the project implemented The survey has resulted to encourage the CWSA (Community World Services Asia) and agreed with public health directorate of Laghman province to establish 6 Sub Health Center and 26 health posts in the surveyed areas. Methodology: A descriptive quantitative survey was conducted in 6 rural villages of Alingar, Alishang, Qarghayee and Mehterlam districts of Laghman province which has taken a period of 4 months duration. A sample of 700 HHs from 52000 population are randomly selected from six big villages, Epi info was used for the sampling. Male and female head of households are interviewed, 95% confidence level and 5% margin of error is estimated. A structured questionnaire is developed and used for the data collection. Eleven couples (male and female) of surveyors are (funded by an INGO), hired who did the survey after they are trained. To ensure the quality of data, the data was checked by five male and female supervisor in the field and re checked by study coordinator in the office. Data is entered and analyzed in excel sheet by NGO (CWSA) expert. Conclusion: It is concluded that 86 % of the HHs in surveyed areas are living in mud mad hoses, men are mostly the head of HHs and 93% are monogamous. Main source of income of family is agriculture (75%) and livestock. Sixty six (66%) of the households heads are illiterate and only 3% of people have access to sanitary latrine and 66% of HHS use unsafe water sources for drinking. Main source of energy is solar boards (67%). Most of the poor health indicators are due to either absence of or prohibitive distance to health facilities. The existing health facilities are underutilized due to their improper location. Poor awareness, poor literacy rate, poor sanitation, unsafe drinking water, poor nutrition and poor vaccination, has caused high morbidity of communicable and non-communicable disease in the areas. Men are the only decision maker in households which poor decision making of women has resulted to increase RH problem. Recommendation: To address the existed problems, numbers of Sub Health Center and health posts should be established with main focus on MNCH (Mother newborn and Child Health) services, community awareness should be in high priority of the health facilities. Addition to this a network for referral system should be in placed to refer the cases on the right time to other level of health facilities.