Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study
Despite efforts to promote gender equality in Afghanistan from 2002 to 2021, the country continues to face significant challenges in women's health, including high rates of unassisted homebirths and maternal mortality. This study explores the influence of gender norms on unassisted homebirths i...
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Elsevier
2025-12-01
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| Series: | SSM: Qualitative Research in Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667321525000794 |
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| author | Ahmad Rashed Wassif Maisam Najafizada Shree Mulay |
| author_facet | Ahmad Rashed Wassif Maisam Najafizada Shree Mulay |
| author_sort | Ahmad Rashed Wassif |
| collection | DOAJ |
| description | Despite efforts to promote gender equality in Afghanistan from 2002 to 2021, the country continues to face significant challenges in women's health, including high rates of unassisted homebirths and maternal mortality. This study explores the influence of gender norms on unassisted homebirths in Afghanistan, where conservative societal norms often dictate women's roles and access to healthcare. A qualitative case study design was employed to explore unassisted homebirths in Afghanistan. Data were collected from Afghan refugee men and women who had relocated to Canada. In-depth interviews were conducted with nine women who had experienced unassisted homebirths, and focus group discussions were held with six men and eight women to gather their experiences and observations of homebirths in their communities.The findings highlight a range of factors, including gender norms that burden women with exhaustive household and agricultural responsibilities, financial dependence on male family members that restricts their autonomy, and male-dominated decision-making processes that severely limit their agency in health-related choices. Additionally, social norms requiring women to seek permission from husbands or a male family member and have a mahram (husband or a permissible male companion) to access healthcare were found to compound barriers to skilled birth attendance.The research underscores the need for gender-sensitive strategies that engage family members, particularly male relatives and mothers-in-law, to promote skilled birth attendance and empower women through health education and improving their economic opportunities to make autonomous health decisions. Addressing these gender norms and power dynamics is crucial for reducing unassisted homebirths. |
| format | Article |
| id | doaj-art-defbcfc7c91c4aa79a51990e059a30e6 |
| institution | Kabale University |
| issn | 2667-3215 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Qualitative Research in Health |
| spelling | doaj-art-defbcfc7c91c4aa79a51990e059a30e62025-08-20T03:28:14ZengElsevierSSM: Qualitative Research in Health2667-32152025-12-01810060110.1016/j.ssmqr.2025.100601Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative studyAhmad Rashed Wassif0Maisam Najafizada1Shree Mulay2Memorial University, Montclair Stat University, Balkh University, Afghanistan; Division of Population Health and Applied Health Sciences, Faculty of Medicine Building, 4th Floor, Office#M4M202, Memorial University, 39 Clinch Crescent, St. John’s, NL Canada A1B 3V6; Corresponding author. Memorial University, Montclair Stat University, Balkh University, Afghanistan, Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University. Office# M4M202. 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.University of Ottawa, Balkh University, Afghanistan; Division of Population Health and Applied Health Sciences, Faculty of Medicine Building, 4th Floor, Office#M4M202, Memorial University, 39 Clinch Crescent, St. John’s, NL Canada A1B 3V6Division of Population Health and Applied Health Sciences, Faculty of Medicine Building, 4th Floor, Office#M4M202, Memorial University, 39 Clinch Crescent, St. John’s, NL Canada A1B 3V6; McGill, CanadaDespite efforts to promote gender equality in Afghanistan from 2002 to 2021, the country continues to face significant challenges in women's health, including high rates of unassisted homebirths and maternal mortality. This study explores the influence of gender norms on unassisted homebirths in Afghanistan, where conservative societal norms often dictate women's roles and access to healthcare. A qualitative case study design was employed to explore unassisted homebirths in Afghanistan. Data were collected from Afghan refugee men and women who had relocated to Canada. In-depth interviews were conducted with nine women who had experienced unassisted homebirths, and focus group discussions were held with six men and eight women to gather their experiences and observations of homebirths in their communities.The findings highlight a range of factors, including gender norms that burden women with exhaustive household and agricultural responsibilities, financial dependence on male family members that restricts their autonomy, and male-dominated decision-making processes that severely limit their agency in health-related choices. Additionally, social norms requiring women to seek permission from husbands or a male family member and have a mahram (husband or a permissible male companion) to access healthcare were found to compound barriers to skilled birth attendance.The research underscores the need for gender-sensitive strategies that engage family members, particularly male relatives and mothers-in-law, to promote skilled birth attendance and empower women through health education and improving their economic opportunities to make autonomous health decisions. Addressing these gender norms and power dynamics is crucial for reducing unassisted homebirths.http://www.sciencedirect.com/science/article/pii/S2667321525000794Unassisted homebirthsGender normsSkilled birth attendanceGender patriarchyQualitative studyAfghanistan |
| spellingShingle | Ahmad Rashed Wassif Maisam Najafizada Shree Mulay Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study SSM: Qualitative Research in Health Unassisted homebirths Gender norms Skilled birth attendance Gender patriarchy Qualitative study Afghanistan |
| title | Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study |
| title_full | Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study |
| title_fullStr | Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study |
| title_full_unstemmed | Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study |
| title_short | Influence of gender norms on unassisted homebirths in Afghanistan: A qualitative study |
| title_sort | influence of gender norms on unassisted homebirths in afghanistan a qualitative study |
| topic | Unassisted homebirths Gender norms Skilled birth attendance Gender patriarchy Qualitative study Afghanistan |
| url | http://www.sciencedirect.com/science/article/pii/S2667321525000794 |
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