Sexual and Reproductive Health Access Among Afghan Refugee Women Using Telehealth in Pakistan

Abstract

Background: Cultural, religious, and gender-based norms critically constrain Afghan refugee women's access to sexual and reproductive health (SRH) services in Pakistan. This study assessed awareness, utilization, and barriers to SRH services and evaluated the Sehat Kahani telemedicine platform's role in improving access.

Methodology: A cross-sectional study was conducted from January to March 2025 at 10 Sehat Kahani e-health clinics in Balochistan and Khyber Pakhtunkhwa. Using purposive sampling, 464 Afghan refugee women aged 18–49 were recruited. Data from structured questionnaires were analyzed in SPSS 26 using descriptive and chi-square statistics (significance p<0.05).

Results: While 76% of participants were aware of SRH services, only 61% had utilized them in the past year. Contraceptives (54%) and pregnancy testing (37%) were most used. Key barriers were limited service hours (35%) and distance (28%). Utilization was significantly associated with age, marital status, income, and household size (all p<0.01). Education showed no link to awareness (p=0.56) but a strong association with utilization (p<0.001).

Conclusion: A significant gap remains between SRH awareness and utilization, driven by structural barriers. Digital health platforms like Sehat Kahani offer a promising avenue to improve access. Strengthening policy support for such culturally sensitive telemedicine interventions is crucial to bridging this gap for refugee populations.