Biopsychosocial Profile of COVID-19 Patients Cared for in Public and Private Health Facilities in Kandahar Province, Afghanistan

Background. Over the past two years, the ongoing COVID-19 pandemic has resulted in a staggering number of biopsychosocial deficits in the general population that have impacted the physical, psychological, and social aspects of their health and well-being. Objectives. This paper highlights the biopsychosocial characteristics of COVID-19 patients cared for in public and private health facilities in Kandahar, Afghanistan. Methods. A cross-sectional study was performed using telephone interviews of patients tested positive for COVID-19 between March 2020 and March 2021. The Pashto version of Depression, Anxiety, and Stress Scale-21 (DASS-21) was administrated to all patients. Independent t-test and ANOVA analyses were used to assess the effects of sociodemographic and clinical characteristics on DASS-21 total scores and on each subscale separately. Results. Of all 477 participants, the vast majority (95%) had characteristic symptoms of COVID-19, such as fever, sore throat, cough, and headache. Of all participants, 472 (99%) had symptoms of anxiety, 462 (96.9%) had depression, and 463 (97.1%) had stress. Patients who scored significantly higher on the DASS-21 scale were more likely to have female sex, old age, low level of education, spouse separation, comorbid medical conditions, and being admitted to intensive care units. Conclusion. This study confirmed the previously described epidemiological and clinical characteristics of patients with severe COVID-19. The results indicated a high burden of mental health problems in severe COVID-19 patients. Hence, we recommend that policymakers in Afghanistan take proper measures for the timely provision of efficient and quality mental health services during every disaster and postdisaster era

Factors Associated with Modern Contraceptive Use among Married Women Attending Comprehensive Health Centers (CHCs) in Kandahar, Afghanistan

Background. Modern contraceptives are highly effective and reliable methods of preventing unintended pregnancies and reducing maternal deaths. Only 22 percent of currently married women use modern methods of contraceptives in Afghanistan. This study assessed the factors associated with modern contraceptive use among married women attending comprehensive health centers (CHCs) in Kandahar Province. Methods. This was an institution-based cross-sectional study that included 325 married women who attended randomly selected comprehensive health clinics in Kandahar between September and October 2019. The total sample size was allocated proportionally to selected health clinics based on the recent 3-month average patients load. We used a consecutive sampling method to select study participants. Data were collected in a structured questionnaire, which included information on respondents’ demographic, socioeconomic, reproductive, and contraceptive experiences. Data was analyzed using SPSS 21.00 statistical software. We used descriptive statistics such as tables and proportions to present data. Binary and multiple logistic regression analyses were carried out to determine factors associated with modern contraceptive use. Results. Out of 325 married women, 127 used modern contraceptives with a prevalence of 39.1% (95%CI=33.7%–44.6%). The results indicated that the area of residence (AOR=2.61, 95% CI 1.43-4.78) and ever use of contraceptives (AOR=14.92, 95% CI 6.88-32.34) are associated with modern contraceptive use among married women attending comprehensive health centers in Kandahar. Conclusion. This study found that modern contraceptive use was higher than reported on the national level. The most persistent factors associated with modern contraceptive use in this study were urban residence and ever use of contraceptives. As a policy measure, family planning programs should be prompted to the rural residency in Kandahar Province