Vol. 3 No. 2 (2019)
Peer Reviewed Articles

The impact of reproductive health services on armed conflict in Afghanistan

Stewart Britten
Wahida Paikan
University of Westminster
This image of the cover of this issue of The Journal of Population and Sustainability has the title in block letters on a grey-green background.

Published 2019-06-01


  • armed conflict,
  • family planning,
  • demographic transition,
  • Afghanistan

How to Cite

Britten, S., & Paikan, W. (2019). The impact of reproductive health services on armed conflict in Afghanistan. The Journal of Population and Sustainability, 3(2), 33–53. https://doi.org/10.3197/jps.2019.3.2.33


Reduction of child mortality while coverage of family planning services remains low may render Afghanistan a testing ground for the theory of demographic transition. Meanwhile there is a vicious circle: young men lacking employment join the Taliban and so increase national insecurity, discouraging industry and reducing employment opportunities. For progress towards peace to be made and sustained, family planning, education and employment need to be major parts of the peace effort, and UN reports need to emphasise more which way the scales tip.


  1. Afghan Public Health Institute, Ministry of Public Health, Central Statistics Organization, ICF Macro, Indian Institute of Health Management Research, World Health Organization/EMRO, 2011. Afghanistan mortality survey 2010. [pdf] Kabul: Government of Afghanistan. Available at: <https://www.usaid.gov/sites/default/files/documents/1871/Mortality%20Survey%202010.pdf> [Accessed 28 February 2019].
  2. Afghanistan Crossroads, 2009. Taliban pay vs. Afghan forces pay. [online] Available at: <http://afghanistan.blogs.cnn.com/2009/12/09/taliban-pay-vs-afghan-forcespay/> [Accessed 28 February 2019].
  3. Agence France-Presse, 2017. Poverty drives child soldiers into Afghanistan’s endless war. Hindustan Times [online] Available at: <https://www.hindustantimes.com/world-news/poverty-drives-child-soldiers-into-afghanistan-s-endless-war/story-MUgQGDKjPjoqisJsID2ZQO.html> [Accessed 28 February 2019].
  4. Bartlett L., Mawji S., Whitehead S., et al., 2005. Where giving birth is a forecast of death: Maternal mortality in four districts of Afghanistan, 1999–2002. Lancet, 365, pp.864–70.
  5. BBC, 2019. Afghanistan’s Ghani says 45,000 security personnel killed since 2014. BBC News. [online] Available at: <https://www.bbc.co.uk/news/worldasia-47005558> [Accessed 28 February 2019].
  6. Beehner, L., 2007. The effects of “youth bulge” on civil conflicts. Council on Foreign Relations. [online] Available at: <http://www.cfr.org/world/effects-youthbulge-civil-conflicts/p13093> [Accessed 28 February 2019].
  7. Bourne, J K, 2015. The end of plenty. Melbourne and London: Scribe.
  8. Britten S., 2017. Maternal mortality in Afghanistan, setting achievable targets. Lancet, 389, pp.1960-62.
  9. Bruce, J. and Bongaarts, J., 2010. The new population challenge. In: L. Mazur, ed. 2010. A pivotal moment. Washington DC: Island Press.
  10. Buhaug, H and Rød, J. K., 2006. Local determinants of African civil wars, 1970– 2001. [pdf] Political Geography 25(3), pp.315–335. Available at: <https://www.hbuhaug.com/wp-content/uploads/2014/02/PG-2006-for-web.pdf> [Accessed 28 April 2019].
  11. Buhaug, H, Cederman, L-E and Rød. J K. 2007. Disaggregating ethnonationalist civil wars: A dyadic test of exclusion theory. [pdf] International Organization 62(3), pp.531–51. Available at: <http://www.icr.ethz.ch/publications/buhaug2007disaggregating.pdf> [Accessed 28 April 2019].
  12. Byrd, W. and Payenda, M.K., 2016. Afghanistan’s government revenue: Continuing robust growth in the face of economic weakness. Afghanistan Analysis Network. [online] Available at: <https://www.afghanistan-analysts.org/afghanistansgovernment-revenue-continuing-robust-growth-in-the-face-of-economicweakness/> [Accessed 28 February 2019].
  13. Carvalho, N, Goldie, SJ and Salehi, AS, 2012. The value of family planning for improving maternal health in rural Afghanistan: The example of Kandahar. Afghan J of Public Health, 1, (1), pp.12-19.
  14. Central Statistics Organization (CSO), 2014. Population (2013–2014). [pdf] Available at: <http://cso.gov.af/Content/files/Population(3).pdf> [Accessed 28 February 2019].
  15. Central Statistics Organization (CSO), 2014a. National risk and vulnerability assessment 2011-12. Afghanistan living condition survey. [pdf] Kabul: CSO. Available at: <http://www.af.undp.org/content/dam/afghanistan/docs/MDGs/ NRVA%20REPORT-rev-5%202013.pdf> [Accessed 28 February 2019].
  16. Central Statistics Organization (CSO), Ministry of Public Health (MoPH), and ICF, 2017. Afghanistan demographic and health survey 2015. [pdf] Kabul: CSO. Available at: <http://cso.gov.af/Content/files/Afghanistan%20DHS%202015%20KIR/AFDHS_Final%20Report.pdf> [Accessed 27 February 2019].
  17. Central Statistics Organization (CSO), 2018. Afghanistan living conditions survey 2016-17. [pdf] Kabul: CSO. Available at: <http://cso.gov.af/Content/files/ALCS/ALCS%202016-17%20Analysis%20report%20%20English%20_compressed(1).pdf> [Accessed 28 February 2019].
  18. Chaudhuri, S., 2018. The latest poverty numbers for Afghanistan: A call to action, not a reason for despair. World Bank Blogs. [online] Available at: <http://blogs.worldbank.org/endpovertyinsouthasia/latest-poverty-numbers-afghanistan-callaction-not-reason-despair> [Accessed 4 May 2019].
  19. Chayes S., 2015. Thieves of state: Why corruption threatens global security. New York and London: Norton.
  20. Das, J. et al., 2018. Scaling up primary health services for improving reproductive, maternal, and child health: A multisectoral collaboration in the conflict setting of Afghanistan. British Medical Journal [e-journal] 363; k4986. https://doi.org/10.1136/bmj.k4986.
  21. Douthwaite, M. and Ward, P., 2005. Increasing contraceptive use in rural Pakistan: An evaluation of the Lady Health Worker Programme. Health Policy and Planning, 2, pp.117–23.
  22. Dyson, T. 2015. Population and development. London and New York: Zed.
  23. Gerland, P. et al., 2014. World population stabilization unlikely this century. Science Vol. 346, Issue 6206, pp.234-237. http://dx.doi.org/10.1126/science.1257469
  24. Giustozzi, A., 2012. Taliban networks in Afghanistan. [pdf] CIWAG Case Studies. 8. Available at: <https://digital-commons.usnwc.edu/cgi/viewcontent.cgi?article=1006&context=ciwag-case-studies> [Accessed 28 February 2019].
  25. Goldstone et al., 2010. A global forecasting model of political instability. [pdf] American Journal of Political Science, Vol. 54, No. 1, pp.190–208. Available at: <https://sites.duke.edu/niou/files/2011/06/goldstone-bates-etal.pdf> [Accessed 4 May 2019].
  26. Huber D, Saeedi N, Samedi A.K., 2018. Achieving success with family planning in rural Afghanistan. Bull World Health Organ, 88, pp.227-31.
  27. Independent Joint Anti-Corruption Monitoring and Evaluation Committee, 2016. Vulnerability to corruption assessment in the Afghan Ministry of Public Health. [pdf] Available at: <http://www.mec.af/files/2016_06_04_MOPH_Special_Report_(English).pdf> [Accessed 28 February 2019].
  28. Islamic Republic of Afghanistan, 2016. Citizens charter. Available at: <http://dmm.gov.af/en/page/citizens-charter> [Accessed 28 February 2019].
  29. Koblinsky, M.A., ed., 2003. Reducing maternal mortality; learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica and Zimbabwe. Washington DC: World Bank.
  30. Landinfo, 2017. Afghanistan: Recruitment to Taliban. [pdf] Oslo: Landinfo, Country of Origin Information Centre. Available at: <https://landinfo.no/asset/3588/1/3588_1.pdf> [Accessed 26 February 2019].
  31. Madsen, E. L., Daumerie, B, and Hardee, K., 2010. The effects of age structure on development: Policy and issue brief. [pdf] Washington DC: Population Action International. Available at: <https://pai.org/wp-content/uploads/2012/01/SOTC_PIB.pdf> [Accessed 15 May 2019].
  32. Malthus, T. 2015 [1798]. An essay on the principle of population. London: Penguin.
  33. Marcus M., Pavignani E., Hill P., 2013. Too good to be true? An assessment of health system progress in Afghanistan, 2002–2012. Medicine, Conflict and Survival, 29, pp.322–45.
  34. Maternal Health Task Force, 2008. Family planning and maternal health. Harvard Chan School. [online] Available at: <https://www.mhtf.org/topics/family-planningmaternal-health/> [Accessed 4 May 2019].
  35. Ministry of Public Health, 2010. A basic package of health services for Afghanistan – 2010/1389, revised policy. Kabul: Ministry of Public Health. Mohmand K.A., 2013. Community midwifery education program in Afghanistan. [pdf] International Bank for Reconstruction and Development/The World Bank. Available at: <http://documents.worldbank.org/curated/en/138781468185951486/pdf/870760WP0Box030fery0Education0FINAL.pdf> [Accessed 28 February 2019].
  36. Najafizada, L., (Head of TOLOnews TV, Kabul) 2017. Personal communication.
  37. Parsa, A. 2018. Personal communication
  38. Parsons, J., 1996. Medicine, population and survival. Medicine, Conflict and Survival 12, pp.23-34.
  39. Population Action International, 2013. Why population matters to security. [pdf] Available at: <http://pai.org/wp-content/uploads/2013/01/Why-PopulationMatters-to-Security.pdf> [Accessed 28 April 2019].
  40. Population Reference Bureau, 2011. Discuss online: Population and national security. [online] Available at: <http://www.prb.org/Publications/Articles/2011/population-national-security.aspx> [Accessed 28 February 2019].
  41. Ryerson W., 2018. The hidden gem of the Cairo Consensus: Helping to end population growth with entertainment media. The Journal of Population and Sustainability, 2 (2), pp.51-62.
  42. Sedgh, G., Ashford, L.S. and Hussain, R., 2016. Unmet need for contraception in developing countries: Examining women’s reasons for not using a method. [pdf] New York: Guttmacher Institute. Available at: <https://www.guttmacher.org/sites/default/files/report_pdf/unmet-need-for-contraception-in-developing-countriesreport.pdf> [Accessed 29 April, 2019].
  43. Shafiqullah H., Keiko, A.M., Seino, N.K, 2018. The family planning conundrum in Afghanistan. Health Promotion International, [e-journal] 33, (2), pp.311–17. https://doi.org/10.1093/heapro/daw081
  44. UNFPA, 2014. Afghanistan state of youth report. UNFPA Afghanistan [pdf] Available at: <https://afghanistan.unfpa.org/sites/default/files/pub-pdf/AfghanistanStateofYouthReport2014.pdf> [Accessed 12 May 2019].
  45. UNFPA, 2015. Investing in youth: How to realize Afghanistan’s demographic dividend. [pdf] UNFPA Afghanistan. Available at: <https://afghanistan.unfpa.org/sites/default/files/pub-pdf/Investing%20in%20Youth%20How%20to%20Realize%20Afghanistan%27s%20Demographic%20Dividend_0.pdf> [Accessed 26 February 2019].
  46. UNICEF, 2019. Afghanistan. Key demographic indicators. [online] Available at: <https://data.unicef.org/country/afg/> [Accessed 26 February 2019].
  47. United Nations DESA, Population Division, 2017. World Population Prospects 2017 [online] Available at: <https://population.un.org/wpp/Graphs/DemographicProfiles/> [Accessed 28 February 2019].
  48. Urdal H and Hoelscher K, 2009. Urban youth bulges and social disorder, an empirical study of Asian and sub-Saharan African cities. [pdf] World Bank Policy Research Working Paper 5110. Available at: <http://documents.worldbank.org/curated/en/833661468202165336/pdf/WPS5110.pdf> [Accessed 28 April 2019].
  49. Wilson Centre, 2013. Afghanistan beyond the headlines: Women, youth, and war. [online] Available at: <https://www.wilsoncenter.org/event/afghanistan-beyondthe-headlines-women-youth-and-war> [Accessed 28 February 2019].
  50. World Bank, 2014. Afghanistan multiple indicator cluster survey 2010–2011. [online] Available at: <http://microdata.worldbank.org/index.php/catalog/1912> [Accessed 28 February 2019].