Sexual and reproductive health and maternal welfare among Afghan refugee women in Pakistan: a systematic review.

Authors

Emily Rotondi, Rashmina J Sayeeda, Carly Ching, David Flynn, Carrie Preston, Muhammad H Zaman

Published in

Frontiers in global women's health. Volume 7. Pages 1645605. Epub Jul 07, 2026.

Abstract

Women and children make up over 70% of Afghan refugees worldwide. Sexual and reproductive health (SRH) is essential for overall well-being, yet Afghan refugee women living in Pakistan face significant barriers to accessing health services. Limited access to this care contributes to numerous negative health outcomes and can have potentially lasting effects on subsequent generations. This review synthesizes evidence on the experiences, knowledge, and challenges faced by Afghan refugee women in accessing SRH services, focusing on maternal welfare.
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this systematic review includes qualitative, quantitative, and mixed-methods studies from January 2000 to January 2026. Searches were conducted in databases including Boston University Online Library Database, PubMed, Science Direct, Web of Science, Embase, and EBSCOhost. Two authors independently screened titles, abstracts, and full-texts followed by completing data extraction. The quality of the study was assessed using the Mixed Methods Appraisal Tool.
The search yielded 679 initial search results, of which 21 studies met the inclusion criteria. Findings highlight a lack of education and awareness regarding medical and pharmaceutical contraceptives and reproductive tract infections. Afghan refugee women were found to face significant barriers to accessing healthcare, including distance, cost, stigma, and inadequate SRH education. 67% of maternal deaths were deemed preventable, and 81% of women who died from maternal-related causes faced barriers to accessing care. This population group experiences a high rate of illiteracy (93.3%), which contributes to difficulties accessing educational materials about pregnancy risk factors, leading to increased instances of pregnancy loss. Few studies examined the effects of long-term SRH interventions, and only one study analyzed how Afghan women in Pakistan exhibit resilience and self-agency in the face of structural oppression.
This review identified key areas of limited research on SRH services and maternal welfare for commonly overlooked demographics within Afghan refugees in Pakistan, such as women of reproductive age. While maternal health outcomes of Afghan refugees have improved since 2000, women still face limited access to essential SRH services, ultimately impacting their well-being and that of future generations.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024577910, PROSPERO CRD42024577910.

PMID:
42483314
Bibliographic data and abstract were imported from PubMed on 22 Jul 2026.

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