A gender analysis of a national community health workers program: A case study of Afghanistan

Said Najafizada, Ivy Bourgeault, Ronald Labonte

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Gender equity can be a neglected issue in health system reforms. This
paper explores the multiple layered gender dynamics of the Afghan
Community Health Worker (CHW) Program within broader health system
reforms in Afghanistan using a qualitative research design. We
interviewed policy makers, health managers, CHWs and community
members in 16 sites in 2013 and 2014. We found that gendered societal
norms interact and influence the Afghan CHW program in a dynamic
way. Gendered social norms around the division of labour tend to
privilege women in terms of access to resources at the community level,
but it is men who hold leadership positions that ultimately decide how
the resources are to be distributed. The Afghan Ministry of Public Health
expresses a commitment to gender equity, but policies on gender are
restricted to reproductive health, thus constraining a gender-equity
approach as focused on maternal and child health. Our explicit gender
analysis not only reveals gender inequities in the Afghan CHW Program
and the broader health system, it also uncovers how a highly gendered
division of health labour provides some opportunities for women’s
empowerment that can disrupt patriarchal role constraints and broader
gender inequities.
Original languageEnglish
Pages (from-to)23-36
Number of pages14
JournalGlobal Public Health: An International Journal for Research, Policy and Practice
Issue number1
Early online date7 May 2018
Publication statusPublished - 2 Jan 2019
Externally publishedYes


  • Gender analysis
  • health programs
  • Afghanistan


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