KABUL, AFGHANISTAN – Women and girls in Afghanistan face life-threatening obstacles to accessing health services under Taliban rule, and restrictive policies are pushing the country’s fragile health system toward collapse, UN Special Rapporteur on human rights in Afghanistan Richard Bennett warned in his latest report.
The report, titled “Women’s and girls’ right to health in Afghanistan,” was presented on Thursday to the United Nations Human Rights Council during its 61st session. It is based on interviews with 137 Afghans from 29 provinces, including former health workers, women affected by restrictions, and members of civil society organizations.
Bennett said the Taliban have implemented an “institutionalized system of gender-based discrimination, oppression and domination” affecting every aspect of women’s lives, from education and employment to freedom of movement and access to healthcare. This system, he said, amounts to crimes against humanity.
Restrictions on Movement and Dress
Among the most immediate barriers are Taliban-imposed requirements that women be accompanied by a male guardian, or mahram, and strict dress codes. Codified in August 2024 under the so-called law on the promotion of virtue and the prevention of vice, these measures restrict women’s independent access to healthcare and place disproportionate burdens on widows, female-headed households, returnees, and those whose male guardians have disabilities.
The report documents cases of women denied urgent care. In Balkh province, a woman was forced to deliver outside a hospital after being refused entry without a mahram. In another instance, a child died after his mother could not reach a hospital in time because her male guardian was unavailable. Ambulance services are often inaccessible to women, with some male operators refusing to communicate with them.
Health workers are also affected. In some provinces, according to the report, a mahram must accompany women to work, remain nearby during their shift, or provide identification to verify the relationship. Failure to comply with dress codes or mahram requirements has led to threats of dismissal or actual job loss.
Gender Segregation in Health Facilities
The report also details the enforcement of strict gender segregation policies in hospitals and healthcare centers across much of the country. In many provinces, women and girls are required to receive treatment in separate spaces, and female healthcare workers are segregated from their male colleagues.
Female doctors are, in some cases, prohibited from interacting with male colleagues, even by telephone. Bennett said these restrictions severely limit opportunities for consultation, clinical supervision, and professional development, with broader consequences for the quality and safety of care.
Taliban officials actively monitor compliance with segregation rules, including inspections that intrude into private patient areas. According to the report, this has discouraged many women from seeking medical treatment altogether.
Impact on Women Health Workers
Healthcare is one of the few sectors where women are allowed to work, but this exemption is inconsistently applied and vulnerable to sudden reversal. In December 2024, Taliban authorities banned women from medical and health training institutions, halting the pipeline of new female doctors, nurses, and midwives.
Bennett described the ban as “completely unjustifiable” and warned that, if left in place, it would lead to “unnecessary suffering, illness and deaths” and could amount to “femicide.”
Women currently make up only 27% of non-specialist physicians, 18% of specialist doctors, and 29% of nurses in Afghanistan, according to the report. With no new female graduates entering the system, the shortage is expected to worsen sharply.
At the same time, many experienced women health workers are retiring, emigrating, or being forced out of their jobs, leaving rural and underserved communities without trained personnel capable of providing safe and culturally acceptable care.
Maternal, Reproductive, and Mental Health
Afghanistan has one of the world’s highest maternal mortality rates. After declining from 1,311 deaths per 100,000 live births in 2001 to 521 in 2023, estimates for 2024 indicate a rise to 638 deaths per 100,000. According to the report, only 66% of women give birth with a skilled attendant, and just 33% receive four or more antenatal visits.
The report highlighted that the shortages of essential medicines, limited female staff, weak referral systems, and facility closures contributed to preventable maternal and neonatal deaths. Around 1.2 million pregnant and lactating women suffer from acute or chronic malnutrition, compounding health risks for mothers and children. Neonatal mortality remains high at 24 deaths per 1,000 live births.
The report also highlights widespread challenges related to menstrual health and hygiene. Persistent poverty has significantly reduced access to menstrual hygiene products, forcing many women and girls to rely on unsafe or inappropriate materials, increasing the risk of infection.
Programs that previously distributed hygiene kits have been reduced, with particularly severe impacts on internally displaced women and returnees. Many women and girls reported feelings of shame and humiliation linked to their inability to maintain hygiene, contributing to social isolation and psychological distress.
On reproductive healthcare, the report notes that under the previous government, abortion was permitted only in limited circumstances to save the mother’s life. Health professionals reported that abortion services continue only under highly restricted conditions, often in private clinics and at prohibitive cost, pushing some women to resort to unsafe methods.
The suspension of earlier legal frameworks by the Taliban, combined with stigma and fear of punishment, has further limited timely access to reproductive healthcare and increased the risk of complications and maternal deaths.
Bennett also noted a growing mental health crisis among women and girls, driven by restrictions on education, employment, and participation in public life. Many reported anxiety, depression, and despair linked to social isolation and loss of autonomy.
Funding Cuts and Health Facility Closures
Afghanistan’s health system is heavily donor-dependent. Around 75% of public health expenditure had previously come from international donors. Abrupt funding cuts in 2025, including by the United States, forced the closure of around 445 health facilities and reduced services in nutrition, water, sanitation, and community health. The 2026 Humanitarian Needs and Response Plan estimates that 21.9 million people require humanitarian assistance, including 14.4 million needing health services.
Bennett said these cuts, combined with Taliban restrictions, risk leaving millions without essential care, with women and girls disproportionately affected.
Calls for Action
The Special Rapporteur urged Taliban authorities to lift the ban on medical education and training for women, remove restrictions on women’s movement, ensure access to quality healthcare, and restore women’s right to work in all sectors.
He also called on UN member states to avoid normalizing or legitimizing the Taliban unless there are verified improvements in human rights, particularly for women and girls. Donors are urged to fully fund humanitarian programs, support NGOs and women-led civil society, and expand education and training opportunities in health-related fields.
“Without urgent and sustained support, millions of Afghans will be left without essential care, with women, girls and gender-diverse persons disproportionately bearing the consequences,” Bennett said. “Greater international responsibility and action are required.”
