Afghanistan seems to be paying a heavy price for the on-going war in its land. The on-going conflict and strict family values that are observed have adversely affected the health of children in this strife-torn nation.
The study, published in the open access journal BMC Public Health, suggested that poor child health could be linked to a lack of maternal education and a lack of autonomy for mothers when seeking healthcare for their children.
In addition, mothers who were married as children tend to have offspring with poorer health.
Child health in Afghanistan is suffering from the impact of war: shortages of water, food and shelter and the forced displacement of families from their homes are all associated with the prevalence of easily preventable illnesses and indicators of chronic poor health.
For the study, Taufiq Mashal from the Graduate School of Tokyo Medical and Dental University led a research team including colleagues from the Ministry of Public Health, Kabul, Afghanistan.
Mortality rate for children under five in this country was reported to be 191/1000 live births.
This is the first study to show that specific family behaviors, along with war may have a profound effect on child health in Afghanistan.
A total of 1327 households from urban and rural areas of Kabul province participated in the study.
The research team recorded height, weight and other health indicators of 2474 children under the age of five.
The mothers of the children were interviewed about their marriage, level of education, access to female physicians and about the level of autonomy they had when making decisions about healthcare for their children.
The study found that 32.5 per cent and 41.5 per cent of children suffered from acute diarrhea and respiratory illnesses (ARI), respectively. The prevalence of emaciation and linear growth retardation was 12.4 per cent and 39.9 per cent, respectively.
There were correlations between these health conditions and family behaviors.
For instance, a mother's lack of autonomy was associated with ARI and growth retardation, while a lack of maternal education and marriage during childhood were found to be associated with the incidence of diarrhea.
According to Mashal, mothers are critical in securing better healthcare for children and particular attention should be paid to maternal autonomy at the household level for promotion of the health status of children in Afghanistan.
Regarding child marriages, not only the married child, but also the children of child-mothers are subject to a number of disadvantages.
"The poor economic and educational status of these women, and their overall immaturity caused by a lack of learning opportunities may have resulted in difficulties in preventing illness in their children," said Mashal.
Mashal calls for a comprehensive effort centered on the enforcement of legislation to remove the barriers preventing women obtaining healthcare for their children.