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Drawing on long-term fieldwork in Badakhshan, a borderland province in the northeast of Afghanistan, the paper explores the role that opium poppy cultivation has played in a marginal high-altitude economy. Framed by the analytic of 'narco-frontiers' and the puzzle of the persistence of small farmers in uneven agrarian transitions, the paper investigates the diversity of market and non-market institutions that operate across the means of production of opium. Rather than seeing opium poppy production as the vanguard of an agrarian transition, it is suggested that it is more of a rearguard action to ensure survival. [ABSTRACT FROM AUTHOR]

Purpose: The use of economic sanctions has grown dramatically in recent decades. Nevertheless, many arguments are presented in the public policy space regarding their effects on target populations. The author presents the first systematic analysis of the effects of sanctions on living conditions in target countries. Design/methodology/approach: This paper provides a comprehensive survey and assessment of the literature on the effects of economic sanctions on living standards in target countries. The author identifies 31 studies that apply quantitative econometric or calibration methods to cross-country and national data to assess the impact of economic sanctions on indicators of human and economic development. The author provides in-depth discussions of three sanctions episodes—Iran, Afghanistan and Venezuela—that illustrate the channels through which sanctions affect living conditions in target countries. Findings: Of the 31 studies, 30 find that sanctions have negative effects on outcomes ranging from per capita income to poverty, inequality, mortality and human rights. The author provides new results showing that 54 countries—27% of all countries and 29% of the world economy— are sanctioned today, up from only 4% of countries in the 1960s. In the three cases discussed, sanctions that restricted the access of governments to foreign exchange limited the ability of states to provide essential public goods and services and generated substantial negative spillovers on private sector and nongovernmental actors. Originality/value: This is the first literature survey that systematically assesses the quantitative evidence on the effect of sanctions on living conditions in target countries. [ABSTRACT FROM AUTHOR]

The rapid collapse of the Afghan state did not come as a surprise to those who are well-versed in the chequered history of the Law and Development Movement. While the Movement's one-size-fits-all modernization project has been largely rejected, such misguided efforts continue under the aims of "building the Rule of Law" or "improving governance." The fallout from the U.S. withdrawal from Afghanistan is a stark reminder for states and multilateral organizations not to overlook the lessons of the Movement that may have been obscured by the different banners under which state- and market-building efforts have been pursued. From the Movement's sincere yet naïve efforts of state-building between the 1950s and 70s, to its swing to build and support markets under the Washington Consensus paradigm in the 80s and 90s, and a later emphasis on good governance through state institutions from the 2000s onwards, it is clear that top-down state-building efforts have had limited success. The paper argues that the failure of the Afghanistan mission may have been avoided if the U.S. had turned to the lessons learned from the law-and-institutions-building enterprises of the past 70 years. Instead, the failure to heed these lessons led to the building of a state akin to a house of cards. By overlooking the importance of embedded cultural institutions, the legitimacy of the state as perceived by its people, and the dynamic interaction between formal and informal institutions, the state-building project in Afghanistan was bound to fail. Following the takeover by the Taliban, the small gains made in Afghanistan over the past two decades on the issues of hunger, poverty, health, and education have seen rapid deceleration and require urgent attention. The critiques outlined in this paper, informed by the experience of the Law and Development Movement, are meant to inform, not discourage, global engagement in advancing the human development agenda in Afghanistan and other fragile contexts. [ABSTRACT FROM AUTHOR]

Purpose: This paper introduces a conceptual lens for leading social change in slums and informal settlements. In line with this aim, the purpose of this case study is to describe the public problem-solving approach of a social change organization situated in an informal settlement through the lens of adaptive leadership, complexity theory and social change leadership (SCL). Design/methodology/approach: This paper follows an engaged reflection tradition. First, the author-practitioners describe an informal settlement case hereafter called ISC in southeast Iran where many people have historically remained undocumented and uneducated. Using complex adaptive systems theory, adaptive leadership and SCL as the conceptual lens, the paper analyzes ISC as a complex adaptive context in which the community and the government are in tension in solving problems, particularly illiteracy. The instrumental case study draws from participant observation and document analysis to describe and examine the endeavors of a community office operating within ISC. Through this reflective analysis, the authors illustrate how a social change organization can effectively tackle public issues like illiteracy within informal settlements. Findings: This paper applies complexity leadership theory to a social context. The study illustrates how social change organizations can support the transformation of informal spaces into adaptive spaces to enact social change. Originality/value: This paper reflects on engagement activity near the insecure borders of Iran, Afghanistan and Pakistan. By extending an organizational-level theory to the public sphere, this paper contributes theoretically to the complexity theory literature. Moreover, it provides a practical insight for community development and slum upgrading projects. [ABSTRACT FROM AUTHOR]

In this paper, I will examine the legal standards of gender persecution and the evolving descriptor gender apartheid as a way to describe the status of women in Afghanistan. The paper also examines other complementary forms of legal accountability procedures to vindicate Afghan women's rights and hold perpetrators accountable under crimes against humanity. Although the current locus of the paper is focused on Afghan women, it has larger implications for all other crimes of gender persecution. [ABSTRACT FROM AUTHOR]

Background. The Afghanistan-China strategic relationship is multifaceted, characterized by economic convergences, security cooperation, and mutual diplomatic support. China's Belt and Road Initiative has played a significant role in deepening ties, especially through infrastructure development in Afghanistan. Purpose. In this paper authors tried to explore Afghanistan and China relations, how China plays an important role in the redevelopment of Afghanistan, discuss the prospects and challenges facing Chinese-Afghan relations, including from a regional perspective and also discussed how China fits into the vacuum left by the US withdrawal. Method. The method used applies a qualitative method that focuses on looking at social phenomena that occur in society. Results. At the same time, a rather stable Afghanistan free from threats by militant and terrorist groups could provide opportunities for China and other regional states to contribute to its post-conflict economic reconstruction and development. Conclusion. At the period since the Taliban took over an Afghanistan emptied of its foreign presence, there has been much more speculation that China will step in to fill the geopolitical, security and economic vacuum left by the West's withdrawal. China surely has direct interests in a stable, developed and well-governed Afghanistan, not least to prevent spillover and assets in the wider regions of Central and South Asia. [ABSTRACT FROM AUTHOR]

This paper aims to explore how Afghanistan is represented in two mainstream Bollywood films from the pre-9/11 period using Orientalism as a theoretical framework. While much literature exists on Afghanistan being Orientalized in Hollywood films, Bollywood representations of Afghanistan have not been studied from similar critical lenses. With the recent takeover of Afghanistan by the Taliban after a twenty-year-long war, it is more urgent than ever today to examine Bollywood representations of Afghanistan given the crucial importance of India as a key geopolitical entity in the region. The paper shall study two films from the pre-9/11 period in order to understand if Bollywood has Orientalized the region like mainstream Hollywood films. Bollywood films well known for taking their influences from Hollywood productions, make it likely to be the case. [ABSTRACT FROM AUTHOR]

Ammonium nitrate and aluminium (AN–Al) has been used as a typical homemade explosive (HME) by non-state actors since the turn of the century. Despite the regulation applied to ammonium nitrate above 16% nitrogen content and an aluminium particle size below 200 µm, their use has been widespread in Afghanistan, Columbia, Iraq, Syria and Yemen. Containers used to utilise AN–Al as a man-portable improvised explosive device (IED) are typically hexahedral in shape, not the spherical or hemispherical geometries used to theorise risk mitigation. This is particularly important in post-blast investigation where explosives of a non-ideal nature are often used in non-spherical containers. Given the breadth of HME available to criminals, the explosion performance of forty hexahedral containers filled with AN–Al of unknown manufacture is examined. Performance of the AN–Al is determined through the surface detonation of these containers on alluvial soil, with apparent crater volume compared to theoretical calculations for spherical charges of TNT detonated in that same medium. A conversion factor for hexahedral main charges to spherical charges is then established to achieve more accurate predictions of the explosion risk using Kingery-Bulmash and Bowen curves. The paper provides worked examples for practical application and a methodology by which predictions of charge mass in other mediums such as asphalt can be determined. [ABSTRACT FROM AUTHOR]

Stand-alone price analysis of illicit opium and coca does not explain why smallholders turn to illicit crops for coping and survival. Under conditions of precarity, illicit crop markets can stimulate productivity. They generate returns that can tame crises and relieve pressures. To smallholders facing marginalisation, violence, and climate change – growing opium and coca, despite their illegality, can reduce or spread risks and provide more predictability. Thus, rather than fix on the 'invisible hand' of price theory, the focus should be on the 'visible hand' of political entrepreneurship, interdependent relationships, and the metrics of precarity. To do this, this paper retrospectively compares illicit crop prices before and after certain historical moments in Bolivia, Myanmar, Colombia, and Afghanistan. [ABSTRACT FROM AUTHOR]

Severe acute malnutrition (SAM) remains a major global public health problem. SAM cases are treated using ready‐to‐use therapeutic food (RUTF) at a dosage of ∼200 kcal/kg/day per the standard treatment protocol (STD). Emerging evidence on simplifications to the standard protocol, which among other adaptations, includes reducing the daily RUTF dosage, indicates that it is effective and safe for treating children with SAM. In response to a foreseen stock shortage of RUTF, the government of Afghanistan endorsed the temporary use of a modified treatment protocol in which the daily RUTF dosage was prescribed at 1000 kcal/day (irrespective of body weight) until the child achieved moderate acute malnutrition status (weight‐for‐height z‐score ≥ −3 or mid‐upper arm circumference [MUAC] ≥ 115 mm), at which point 500 kcal/day was prescribed until cured (modified treatment protocol [MTP]). In this paper, we report the results of this nonweight‐based daily RUTF dosage experience. Data of 2042 children with SAM, treated using either the STD protocol (n = 269) or the MTP protocol (n = 1773) from August 2019 to March 2021 in five provinces, were analyzed. The per‐protocol analyses confirmed noninferiority of MTP protocol when compared to STD protocol for recovery rate [93.3% vs. 90.2%; ∆ (95% confidence interval, CI) = 3.1 (−0.9; 7.2) %] and length‐of‐stay [82.6 vs. 75.6 days; ∆ (95% CI) = 6.9 (3.3; 10.5) days], considering the margin of noninferiority of −10% and +14 days, respectively. Weight gain velocity was smaller in the MTP protocol group than in the STD protocol group [3.7 (1.7) vs. 5.2 (2.9) g/kg/day; ∆ (95% CI) = −1.5 (−1.8, −1.2); p < 0.001]. The STD group had a significantly higher mean than the MTP group for absolute MUAC gain [∆ (95% CI) = 1.7 (1.0; 2.3) mm; p < 0.001] and the MUAC velocity [∆ (95% CI) = 0.29 (0.20; 0.37) mm/week; p < 0.001]. Our results confirm the noninferiority of a nonweight‐based daily dosage and support the endorsement of this modification as an alternative to the standard protocol in resource‐constrained contexts. Key messages: More evidence supporting the use of the nonweight‐based daily ready‐to‐use therapeutic food (RUTF) dosage for treating uncomplicated severe acute malnutrition (SAM), in specific contexts, is needed.Our real‐world prospective nonrandomized study showed that the fixed nonweight‐based daily RUTF dosage protocol is as effective as the standard weight‐based protocol for treating uncomplicated SAM in children <5 in the Afghanistan context.Our findings support the reflection of a nonweight‐based daily RUTF dosage in resource‐constrained contexts in national and global policies and guidelines to improve coverage of all children in need of treatment. [ABSTRACT FROM AUTHOR]

This paper contributes to the critical hydropolitics literature by introducing the power–interests–identity nexus framework and addresses how it shapes decisions and (re)actions to transform or maintain water conflicts. The framework is investigated using the Helmand/Hirmand river basin, shared by Afghanistan and Iran. It elucidates which factors led to the transformation of Iran–Afghanistan water conflicts and the signing of the 1973 Treaty, as well as the influential factors that have contributed to its maintenance in the 2020s. The results demonstrate using the framework provides comprehensive insight by identifying the influential latent factors of transboundary water arrangements. [ABSTRACT FROM AUTHOR]

Background/Objective: This study aimed to identify COVID-19 vaccine hesitancy among medical students in Helmand, Afghanistan, and its contributing factors. The findings will be presented to key healthcare organizations for peer review and used to develop a regional Risk Communication and Community Engagement (RCCE) strategy to increase national vaccine acceptance among medical students. Methods: This study employed a structured approach consisting of three steps. First, a paper-based Knowledge, Attitude, and Practice (KAP) questionnaire was developed and tested for efficacy and understanding. Second, using Yamane's formula to determine the appropriate sample size, a population-based stratified sampling method was employed to select 200 respondents from 937 medical students in 21 classes. Results: A survey conducted in February 2022 revealed a high percentage (38.6%, or 56 out of 145) of medical students hesitant to receive SARS-CoV-2 vaccination in Helmand, Afghanistan. Factors contributing to this hesitancy include a lack of information about COVID-19 vaccination, doubts about its adverse effects, and fear of long-term sequelae associated with immunization. Conclusion: The results of this study provide valuable insights for professors, policymakers, and health organizations to address factors contributing to COVID-19 vaccine hesitancy among medical students. Approaches such as RCCE campaigns, public awareness initiatives, and incorporating a dedicated vaccination chapter into the medical curriculum can minimize hesitancy and increase vaccine acceptance. Addressing vaccine hesitancy is crucial to prevent the spread of COVID-19 and protect the health of medical students at higher risk due to their proximity to infected populations. [ABSTRACT FROM AUTHOR]

Why did the nuclear dominoes stop in Afghanistan? This paper is a logical analysis of this question. Nuclear dominoes are common in rival relations characterized by geographic proximity, ongoing military conflict, and mutual hostility. The U.S.– USSR–China–India–Pakistan cascade of nuclear weapons development is empirical evidence of this phenomenon. However, despite the development of nuclear weapons by its arch-enemy Pakistan, Afghanistan did not proliferate in response. This study identifies and validates the reasons why Afghanistan did not (or could not) develop nuclear weapons, categorized into threat, capability, and constraint factors. The most significant finding is that Afghanistan did not perceive Pakistan’s nukes as a threat in terms of intention. Of course, it is also possible to argue that Afghanistan lacked the capacity to bear the various costs of developing nuclear weapons and that structural constraints imposed by international nonproliferation commitments, great power coercion, and regional balance of power dynamics prevented it from doing so. However, the root cause was the symbiotic relationship between the Taliban regime and Pakistan, temporarily easing the enduring rivalry, resulting in a bias in threat perception. These findings are consistent with the constructivist view of the importance of “shared understanding” in threat perception and challenge the realist perception that nuclear dominoes are inevitable in rivalry relationships. They are also significant because they provide clues for peace and stability in East Asia, one of the regions most likely to experience nuclear dominoes. [ABSTRACT FROM AUTHOR]

The Taliban 2.0 in Afghanistan took the world by surprise. This article investigates how this event was seen differently in varied contexts, such as neighboring Pakistan. Our research shows epistemological pluralism in Pakistan, i.e. how different groups use different ways of knowing (epistemology), being (ontology), and valuing (axiology) to explain and analyze Taliban 2.0. Conceptually, the paper draws on insights from the relationality theory to demonstrate the reasons behind such epistemological pluralism. The theory of relationality provides the grounds for epistemological pluralism, i.e. the mixed sentiments and feelings among respondents about the Taliban 2.0 in Afghanistan. Our research reports the perspectives of nine selected civil society activists about Taliban 2.0 in Afghanistan and its implications for Pakistan. The respondents were interviewed during the second quarter of the Taliban administering Afghanistan. Some called it the victory of Islam, the freedom of Afghans from foreign occupation, and the protection of the Pakistani border from Indian proxies. Others were worried about the risks of increased extremism and terrorism in Pakistan, including the rise of banned organizations like Tehrik-e-Taliban Pakistan. This study intends to document the interviewee civil society activists' suggestions to the State of Pakistan for dealing with Taliban-ruled Afghanistan. [ABSTRACT FROM AUTHOR]

This paper presents a multi-parameter ionospheric disturbance analysis of the total electron content (TEC), density (Ne), temperature (Te), and critical frequency foF2 variations preceding two significant earthquake events (2015 Mw 7.5 and 2023 Mw 6.3) that occurred in Afghanistan. The analysis from various ground stations and low-Earth-orbit satellite measurements involved employing the sliding interquartile method to process TEC data of Global Ionospheric Maps (GIMs), comparing revisit trajectories to identify anomalies in Ne and Te from Swarm satellites, applying machine learning-based envelope estimation for GPS-derived TEC measurements, utilizing the least square method for foF2 data and ionograms obtained from available base stations in the Global Ionosphere Radio Observatory (GIRO). After excluding potential influences caused by solar and geomagnetic activities, the following phenomena were revealed: (1) The GIM-TEC variations displayed positive anomalies one day before the 2015 Mw 7.5 earthquake, while significant positive anomalies occurred on the shock days (7, 11, and 15) of the 2023 Mw 6.3 earthquake; (2) the Swarm satellite observations (Ne and Te) for the two earthquakes followed almost the same appearance rates as GIM-TEC, and a negative correlation between the Ne and Te values was found, with clearer appearance at night; (3) there were prominent positive TEC anomalies 8 days and almost 3 h before the earthquakes at selected GPS stations, which were nearest to the earthquake preparation area. The anomalous variations in TEC height and plasma density were verified by analyzing the foF2, which confirmed the ionospheric perturbations. Unusual ionospheric disturbances indicate imminent pre-seismic events, which provides the potential opportunity to provide aid for earthquake prediction and natural hazard risk management in Afghanistan and nearby regions. [ABSTRACT FROM AUTHOR]

Accurate and efficient post-earthquake building damage assessment methods enable key building damage information to be obtained more quickly after an earthquake, providing strong support for rescue and reconstruction efforts. Although many methods have been proposed, most have limited effect on accurately extracting severely damaged and collapsed buildings, and they cannot meet the needs of emergency response and rescue operations. Therefore, in this paper, we develop a novel building damage heterogeneity enhancement network for pixel-level building damage classification of post-earthquake unmanned aerial vehicle (UAV) and remote sensing data. The proposed BDHE-Net includes the following three modules: a data augmentation module (DAM), a building damage attention module (BDAM), and a multilevel feature adaptive fusion module (MFAF), which are used to alleviate the weight deviation of intact and slightly damaged categories during model training, pay attention to the heterogeneous characteristics of damaged buildings, and enhance the extraction of house integrity contour information at different resolutions of the image. In addition, a combined loss function is used to focus more attention on the small number of severely damaged and collapsed classes. The proposed model was tested on remote sensing and UAV images acquired from the Afghanistan and Baoxing earthquakes, and the combined loss function and the role of the three modules were studied. The results show that compared with the state-of-the-art methods, the proposed BDHE-Net achieves the best results, with an F1 score improvement of 6.19–8.22%. By integrating the DBA, BDAM, and MFAF modules and combining the loss functions, the model's classification accuracy for severely damaged and collapsed categories can be improved. [ABSTRACT FROM AUTHOR]

This paper traces the making of Bamiyan Buddhas beyond the Bamiyan valley in Afghanistan since 2002. Recounting the building and rebuilding of a monastic complex in Bangkok, the study focuses on one of these new Buddhas, more complete than the "original" Bamiyan Buddha of the dually inscribed grotto, "Bamiyanguha-Bamiyan Museum", at Wat Saket. In their global manifestations, the Bamiyan Buddhas have emerged as mobile sites, as place holders with direct and indirect citations to the destroyed Buddhas of the valley. The building of Wat Saket's Bamiyan Buddha is situated within larger transnational histories of planned, projected, rejected, and reproduced Bamiyan Buddhas, within stylistic decisions related to questions of shifting material media, scale, and iconography involved in copying and reproductions, in the context of Thailand's changing engagements with itinerance, multiplication, and copying strategies around Buddha images, and in national and global circuits of collecting, exhibitions, gift, and piety. The museum, specifically the cave-museum of Wat Saket, as a site of retinal and haptic vision which continues to challenge and blur the distinctions between curatorial visions, specialist pedagogy, visual instructions, aesthetic contemplation, and rapidly shifting and evolving complex of ritual practices and leisure, remains at the heart of this study. [ABSTRACT FROM AUTHOR]

Following the dramatic evacuation from Kabul airport in August 2021, the UK government proclaimed its commitment to a 'warm welcome' for Afghans. In this paper we draw on original qualitative research to explore the emerging experiences of evacuees, and other recent arrivals, during their first year in London. Using the narratives of our Afghans participants, as well as insights from key stakeholders, we show how they navigated slow, opaque bureaucratic processes and lack of communication with official agencies. As a result of these lengthy processes, many thousands of evacuees remained in temporary hotel accommodation for protracted periods. Drawing on the concept of 'everyday bordering', we explore the extent to which Afghan resettlement policies are achieving their objectives. We consider how such policies are birthed within a punitive immigration system, which is designed to 'wear down' migrants in the UK, regardless of their reason for migration. Moreover, we argue that the ad hoc response of the Home Office and the Foreign Office has created 'false distinctions' between categories of Afghan refugees, reinforcing notions of 'deserving' versus 'underserving' migrants. This distinction allows the government to present itself as humanitarian, 'rescuing' people from Afghanistan, while simultaneously maintaining its commitment to the 'hostile immigration environment'. [ABSTRACT FROM AUTHOR]

This paper uses critical discourse analysis and critical literacy to analyze the first in a series of literacy primers developed with US support for children in Afghanistan in the 1980s, called 'Jihad literacy'. The text is analyzed for its ideological content as related to the themes of religion, violence, and martyrdom in the historical perspective of the Cold War and the Soviet Union's invasion of Afghanistan. The paper demonstrates how the notion of 'Jihad' was subverted to promote a holy war against the Soviet invasion. The educational system supported by the US created a radical version of Islam based on violence and martyrdom, shaping the Afghan society to this day. We contend that the same or similar institutions shape current discourses as in the past and that children are the main victims of politico-economic warfare. [ABSTRACT FROM AUTHOR]

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Purpose: This research paper aims to delve into the perceptions of health susceptibility among Iranian, Afghan and Tajik individuals hailing from asylum-seeking or refused asylum-seeking backgrounds currently residing in Finland, Norway and Sweden. Design/methodology/approach: Semi-structured interviews were conducted between May and October 2022 involving a sample size of 27 participants. An adapted framework based on the health belief model along with previous studies served as a guide for formulating interview questions. Findings: Notably influenced by cultural background, religious beliefs, psychological states and past traumatic experiences during migration journeys – before arrival in these countries till settling down – subjects' perception of health concerns emerged significantly shaped. Additionally impacting perspectives were social standing, occupational status, personal/family medical history, lifestyle choices and dietary preferences nurtured over time, leading to varying degrees of influence upon individuals' interpretation about their own wellness or illness. Practical implications: Insights garnered throughout the authors' analysis hold paramount significance when it comes to developing targeted strategies catering culturally sensitive health-care provisions, alongside framing policies better aligned with primary care services tailored explicitly around singular demands posed by these specific communities dwelling within respective territories. Originality/value: This investigation represents one among few pioneering initiatives assessing perceptions regarding both physical and mental well-being within minority groups under examination across Nordic nations, unveiling complexities arising through intersecting factors like individual attributes mingling intricately with socio-cultural environments, thereby forming unique viewpoints towards health-care belief systems prevalent among such population segments. [ABSTRACT FROM AUTHOR]

Injury related to blast exposure dramatically rose during post-911 era military conflicts in Iraq and Afghanistan. Mild traumatic brain injury (mTBI) is among the most common injuries following blast, an exposure that may not result in a definitive physiologic marker (e.g., loss of consciousness). Recent research suggests that exposure to low level blasts and, more specifically repetitive blast exposure (RBE), which may be subconcussive in nature, may also impact long term physiologic and psychological outcomes, though findings have been mixed. For military personnel, blast-related injuries often occur in chaotic settings (e.g., combat), which create challenges in the immediate assessment of related-injuries, as well as acute and post-acute sequelae. As such, alternate means of identifying blast-related injuries are needed. Results from previous work suggest that epigenetic markers, such as DNA methylation, may provide a potential stable biomarker of cumulative blast exposure that can persist over time. However, more research regarding blast exposure and associations with short- and long-term sequelae is needed. Here we present the protocol for an observational study that will be completed in two phases: Phase 1 will address blast exposure among Active Duty Personnel and Phase 2 will focus on long term sequelae and biological signatures among Veterans who served in the recent conflicts and were exposed to repeated blast events as part of their military occupation. Phase 2 will be the focus of this paper. We hypothesize that Veterans will exhibit similar differentially methylated regions (DMRs) associated with changes in sleep and other psychological and physical metrics, as observed with Active Duty Personnel. Additional analyses will be conducted to compare DMRs between Phase 1 and 2 cohorts, as well as self-reported psychological and physical symptoms. This comparison between Service Members and Veterans will allow for exploration regarding the natural history of blast exposure in a quasi-longitudinal manner. Findings from this study are expected to provide additional evidence for repetitive blast-related physiologic changes associated with long-term neurobehavioral symptoms. It is expected that findings will provide foundational data for the development of effective interventions following RBE that could lead to improved long-term physical and psychological health. [ABSTRACT FROM AUTHOR]

Nearly a century after Afghanistan gained independence in 1919, the question of autonomy and originality in the nation's 20th-century foreign policy remains a topic of contention within the country. Following its independence, Afghanistan found itself in a unique situation shaped by the influence of major global powers' competition. Over the past century, geopolitical shifts have significantly influenced both the internal and external circumstances of Afghanistan. This article seeks to address the query: How did regional geopolitical developments impact Afghanistan's foreign policy from the time of its independence to the events of September 11, 2001? This article is descriptive-analytical in which the relationship between the geopolitics of the region and Afghanistan's foreign policy is examined. The geopolitical situation of Afghanistan in the geopolitical theory of the world order of Saul Cohen has shaped the theoretical discussion of the author, Afghanistan as a quasiindependent state in the geopolitics of the region, not just in the post-Cold War period. The special feature of Afghanistan in the region has been prominent since the independence of this country until now. The findings of this paper show that the foreign policy of Afghanistan after independence in the phases of geopolitical stability and transformations in the security structure of the region is more towards a neutral and balanced strategy. The country has had relations with the great powers of every period and has always distanced itself from such a strategy. It is and the independent or what was once a semi-independent position in the regional geopolitics has evolved into a pivotal and crucial region with the accompanying strategy with great power, coup, revolution and even military occupation has also occurred in this country. [ABSTRACT FROM AUTHOR]

The sexual exploitation of adolescents has recently gained international attention and is a major problem in many countries. Afghanistan, a South Asian nation, is one of these countries with a startlingly high rate of sexual exploitation incidents; among these, the practice known as Bacha Bazi has attracted criticism from all sides. In The Kite Runner, Hosseini exposes the terrible Afghan culture of Bacha Bazi, which damages the social and sexual identities of many Afghan boys and has a negative impact on their mental well-being as a result of traumatic events that cause them to exhibit PTSD symptoms. This paper explores the issue of child sexual exploitation in general, as well as the arrival of Bacha Bazi in Afghanistan and its effects on children's mental health in particular, as depicted in The Kite Runner. [ABSTRACT FROM AUTHOR]

Women face multiple socio-economic, cultural, contextual, and perceived barriers in health service utilization. Moreover, poor autonomy and financial constraints act as crucial factors to their healthcare accessibility. Therefore, the objective of the present study is to study the association between health care utilization barriers and women empowerment, including asset ownership among currently married women in Afghanistan. Data of 28,661 currently married women from Afghanistan demographic health survey (2015) was used to carry out this study. Barriers to access healthcare were computed based on problems related to permission, money, distance, and companionship, whereas women empowerment and asset ownership were computed as potential covariates along with other socio-economic risk factors. Bivariate and logistic analysis was carried out to study the association and odds of explanatory variables. Our results confirm the significant and strong association between the barriers to access healthcare and various explanatory variables. Women having any decision-making autonomy are less likely to face any odds [(AOR = 0.56, p < 0.001), CI: 0.51–0.61] among the currently married women than those who don't have any decision-making authority. Similarly, women who justify their beating for some specific reasons face the greater difficulty of accessing health care [(AOR = 1.76, p < 0.001), CI: 1.61–1.93]. In terms of asset ownership, women having any asset ownership (land or household) are less likely to face any barriers in health services utilization given the lower odds [(AOR = 0.91, p < 0.001), CI: 0.90–0.98]. Accessing maternal health is a crucial policy challenge in Afghanistan. A substantial proportion of women face barriers related to approval, money, distance, and companionship while accessing the health services utilization in Afghanistan. Similarly, women empowerment and asset ownership are significantly associated with health service accessibility. This paper therefore suggests for some policy interventions to strengthen the healthcare needs of women and ensure healthcare accessibility by scaling down these potential barriers like poor autonomy, asset ownership and domestic violence. [ABSTRACT FROM AUTHOR]

Even in intense combat scenarios, a significant proportion of a soldier's time is spent passing the time. Tim Hetherington was acutely aware of this contradiction; of the 240 pages of Infidel, his account of the time he spent in Combat Outpost Restrepo in the remote Afghan Korengal valley, only about one sixth show soldiers actually in combat. The remaining pages depict soldiers maintaining their base, passing the time playing cards, wrestling each other, and sleeping. This focus on the lacunary moments between skirmishes and contacts marks out the work as attuned to a more complex understanding of the nature of soldiering in front line situations. This paper situates Hetherington's work into a longer historical engagement with the depiction of soldiers 'killing time' between moments of combat, and in the context of how the homosocial nature of the proximity in which soldiers live and work contributes to their combat motivation. [ABSTRACT FROM AUTHOR]

Using a conflict model to analyse Majority-Minority relations (M-M), this paper focuses on the Hazara community in Afghanistan. Assuming M-M relations are power relations, the struggle for control among divergent ethnic groups has persisted. The Hazaras have historically resided in several provinces and experienced various forms of targeted violence. Millions have fled to other countries to escape persecution. This research diverges from dominant approaches that focus only on ethnicity and religion as the causes of violence against the Hazaras. Instead, the paper examines other factors that have been largely neglected by conflict studies literature. Based on historical data, the study finds that the Hazaras' geostrategic location in Afghanistan, their alliances with Pashtun tribes, and their struggle for autonomy have been the primary factors contributing to the targeted violence against them. Therefore, while ethnicity and religion may have made the Hazaras vulnerable to violence, they are not the main causes of violence. [ABSTRACT FROM AUTHOR]

The terror encountered by women in Afghanistan because of the military withdrawal of United States and its allies in the summer of 2021 is ongoing. The first part of this paper describes emergency clinical interventions provided to two young university Kabul women wishing to escape the Taliban. The second part of this paper explores ideas about moral injury and this psychologist-psychoanalyst's motives for focusing on the survival of the two women. [ABSTRACT FROM AUTHOR]

The European Union (EU) reshapes its position on Afghanistan in the post-US withdrawal scenario, witnessing Taliban re-entrance to the power corridors. By stopping all preferences immediately after the Taliban takeover in August 2021, the EU decided to continue only an operational engagement with the new Afghan administration which was necessary for logistical, operational, and humanitarian purposes. This research paper aims to investigate the EU's responses towards Afghanistan, particularly in terms of its strategic engagement with Kabul, which intends to limit humanitarian assistance and other necessary activities in the war-torn country. A situation analysis of the empirical process was employed as a research technique to investigate the EU's new stance over Afghanistan following the Taliban's reemergence in the country. The study nds that human rights violations, ineffective rules of law, lack of social justice, and security issues led to the lack of interest of the international community including the EU in enhancing trade and economic cooperation with the country. The paper argues that to reopen doors to the international community including the EU, the Taliban regime needs to full its international commitments concerning human rights and security issues. [ABSTRACT FROM AUTHOR]

People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or 'touchpoints' including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing. [ABSTRACT FROM AUTHOR]

Intelligence scholars routinely portray intelligence oversight as a means of restraining intelligence activities, particularly covert operations. The consensus overlooks situations where oversight can instead channel popular passions. This paper documents how Reagan era activists recruited legislators to the Afghan resistance cause. Their legislative-civic alliance demanded the CIA launch more aggressive operations in Afghanistan, sidelining established oversight committees. The resulting covert action campaign risked Soviet escalation, eliminated plausible deniability, and gave advanced U.S. technology to potential terrorists. This episode highlights how well-organized lobbyists may affect the intelligence agenda and challenges assumptions that wider engagement in oversight will always restrain intelligence agencies' overreach. [ABSTRACT FROM AUTHOR]

Pashto is a major language of the Iranian family with multiple dialects spoken in Pakistan and Afghanistan. In this paper, I examine the phonological inventory of the previously little known Khatak Pashto by a comparison with the well‐known Yusufzai, of the Northeast dialect of the language. I use primary data collected from Karak and Mardan districts of northwest Pakistan. In my analysis, I identify the similarities between these two varieties and the differences, based on at least eleven phonological isoglosses including the feature of vowel nasality, which split the two. I conclude by supporting the case for a distinct Central dialect area to represent the position of Khatak Pashto. [ABSTRACT FROM AUTHOR]

Poverty was already a main problem in Afghanistan even before, but it has exacerbated due to the pandemic. However, the actual impact of the pandemic on households had not been investigated. This study provides such analysis using data obtained from a strictly random survey of 1060 households in the capital of Balkh, the fourth most populated province in Afghanistan. Using headcount ratio and poverty gap measures and both income and expenditure approaches, the results show that an additional 12% of households fell below the poverty line, from an already high of 75% before the pandemic. The poverty gap index rises to 34%, but the computed Gini coefficient indicates no significant change in inequality. Poor governance and corruption in Afghanistan are major impediments to address the issue of poverty. This paper suggests several measures which can be implemented to have effective policies and governance to alleviate poverty. [ABSTRACT FROM AUTHOR]

Background and aims: The use and manufacture of methamphetamine has increased in Afghanistan in recent years. Recent research and reports have pointed to the ephedra plant, which grows wildly, as a key source of ephedrine used in the manufacture of methamphetamine. This paper aimed to estimate the relative efficiencies and scale of inputs required to manufacture methamphetamine in Afghanistan. Methods: Monte Carlo simulations model of the amount of ephedra or cold medications needed to render a pure kilogram of methamphetamine in Afghanistan, accounting for uncertainty in ranges of key parameters informed from the literature and elsewhere. Final estimates were extrapolated to recent seizure totals. Results: For dried ephedra, the median estimate is 196.8 kg (25th–75th percentiles 119.3–346.6 kg) needed to produce 1 kg of methamphetamine compared with 27.9 kg (25th–75th percentiles 21.9–36.8 kg) for cold medications. Nearly 2.7 t of methamphetamine were seized in Afghanistan in 2021. Assuming a purity range of 50%–90%, some 266–478 t of dried ephedra or 38–68 t of cold medication would need to have been processed. Conclusion: Simulated estimates show that considerable amounts of either ephedra or cold medication are needed to produce 1 kg of methamphetamine in Afghanistan. This raises questions about the plausibility of ephedra as the dominant source of Afghanistan's methamphetamine. [ABSTRACT FROM AUTHOR]

This paper compares the design feasibility and economic advantage of photovoltaic (PV)-diesel generator (DG)-battery, PV-wind-battery, and PV-biogas (BG)-battery hybrid systems. The objective of this study is to investigate the performance of the three hybrid renewable energy systems (HRES) for sustainable electricity supply in remote areas of Afghanistan. Hybrid optimization model for multiple energy resources (HOMER) software was utilized to perform modeling, optimization, economic, sensitivity, and multi-year analysis of the hybrid systems. The findings indicates that the PV-biomass-battery hybrid system with $175,938 net present cost (NPC) and $0.29/kWh cost of energy (COE) is the most appropriate approach than the PV-DG-battery, PV-wind-battery and diesel-only system. However, the COE in optimal HRES is higher than the COE supplied by Afghanistan's national grid to the household resident in large cities, but COE in the hybrid system is about 37% lower than the cost of energy in the study area and some provinces of Afghanistan. The multi-year analysis was performed on the PV-biogas-battery hybrid system with considering a 0.8% yearly degradation of PV panels and a 2% load increase annually. The results show about an 11.2% increase in NPC and a 6.2% decrease in COE compare to the system without multi-year consideration. Moreover, the outputs from HOMER were evaluated using the Simplex algorithm. The results indicate that there were no significant variations in the results from HOMER and Simplex algorithms. Therefore, this illustrates that the simulations were consistent. The study's findings are anticipated to be helpful to stakeholders, decision-makers, and investors to achieve the goals and increase the electricity access rate in remote areas of Afghanistan. [ABSTRACT FROM AUTHOR]

When Operation Enduring Freedom (OEF) commenced in October 2001, the U.S. Special Forces (SF) were the first U.S. military unit on the ground in Afghanistan, utilising their Unconventional Warfare (UW) capabilities. Despite their significant role at the initial stage of the military campaign, SF began to encounter numerous challenges from as early as 2002 and throughout OEF. Based on an analysis of forty-five master's theses authored by SF officers, this paper discusses the structural-organisational and cultural-conceptual challenges. These obstacles led to the marginalisation of SF's UW efforts. Scholarship on special operations forces (SOF) often regards the period of the so-called global war on terrorism (GWOT) as U.S. SOF's golden age focusing predominantly on the activities of SOF units linked to the U.S. Joint Special Operations Command rather than on SF. By examining the challenges faced by SF, this article aims to contribute to a more nuanced discussion of SOF efforts during GWOT. [ABSTRACT FROM AUTHOR]

This paper aims to analyze the individual's socioeconomic and demographic determinants of financial inclusion and its barriers among for South Asian countries in the lens of existing financial inclusion policy, using World Bank Global Findex database for the period 2011, 2014, 2017, and 2021. We use the Probit regression model to explore the main objective of this study. In addition, we also analyze the trend, pattern, and barriers of financial inclusion for the period 2011- 2021 to identify differences among south Asian countries. Our results reveal that Sri Lanka is the best performer in the inclusivity of financial products as well as removing barriers to financial inclusion in all four periods. While Pakistan and Afghanistan are the least financially included countries, also they failed to remove barriers to financial inclusion. Moreover, our empirical results suggest that individuals who are male, older, wealthier, and more educated are more likely to access financial services, with income and education exerting a higher influence. Further, age shows a non-linear (inverted U-shaped) relationship with financial inclusion indicators. Additionally, we found that individuals having a formal account are the most important indicators of financial inclusion. And the reasons for financial exclusion (i.e., not having an account) are mainly voluntary among South Asian individuals. In fact, it is found that policies like Pradhan Mantri Jan Dhan Yojana for India and National Financial Inclusion Strategy across all South Asian countries play a significant role in accelerating financial inclusion and helping in removing its barriers with different magnitudes. Therefore, our finding stresses the importance of heterogeneous integrated policy measures for the targeted groups of the population, particularly the most vulnerable group among South Asian countries. [ABSTRACT FROM AUTHOR]

Iran has been among the top ten largest refugee‐host countries worldwide, sheltering one of the largest groups of forced migrants from Afghanistan during the past four decades. This policy paper briefly examines and summarizes the policies related to education of Afghan children in Iran through a structured review. The results of this review suggest that higher education has been and continues to be heavily restricted for Afghans. While access to primary education has improved for Afghans in Iran, policies continue to neglect both cultural specificity and unique needs of this group. Therefore, enrolment has remained restricted. The findings of our policy analysis call for further attention to culturally relevant education, financial assistance for families living in poverty and interventions to subsidize the cost of education to ensure access of all Afghan children to primary education and retain enrolment. Results also call for reconsiderations in restrictive higher education policies for Afghans in Iran. [ABSTRACT FROM AUTHOR]

INTRODUCTION Understanding the current burden of stomach cancer linked to smoking and the variations in trends across different locations, is crucial for developing effective prevention strategies. In this study, we present findings on the age-standardized death rate (ASDR) and age-standardized disability-adjusted life years (DALYs) rate attributed to smoking in 204 countries and territories spanning 21 regions from 1990 to 2019. METHODS The data for this study were obtained from the Global Burden of Disease Study (GBD) 2019, which assessed 369 diseases and injuries, as well as 87 risk factors in 204 countries and 21 regions. To assess the trend in ASDR and agestandardized DALYs rate, the estimated annual percentage change (EAPC) was utilized. RESULTS Between 1990 and 2019, smoking was found to be associated with a decrease in ASDR (EAPC = -2.20) and age-standardized DALYs (EAPC = -2.42) rates for gastric cancer. As the sociodemographic index (SDI) increased, the decline in rates also increased gradually. However, the decline was smallest in regions with low SDI (EAPCASDR = -1.34; EAPCage-standardized DALYs rate = -1.38). In 21 regions, both ASDR and DALYs rates experienced a decline. The smallest decline in ASDR was observed in Western Sub-Saharan Africa, with an EAPC of -0.80, while the smallest decline in DALYs rate was found in Oceania, with an EAPC of -0.81. Among the 204 countries analyzed, the Dominican Republic showed the highest increase in ASDR and age-standardized DALYs rate (EAPCASDR = 1.19; EAPCage-standardized DALYs rate = 1.21), followed by Afghanistan (EAPCASDR = 1.09; EAPCage-standardized DALYs rate = 1.09) and Sao Tome and Principe (EAPCASDR = 1.05; EAPCage-standardized DALYs rate = 1.03). In the year 2019, the highest ASDR and age-standardized DALYs rate was observed in East Asia, with the highest rates occurring in Mongolia. CONCLUSIONS The burden of stomach cancer worldwide, adjusted for age, and related to smoking, has shown a decline from 1990 to 2019. However, regional disparities have been identified, with some areas experiencing an increase in this burden. These regions with a higher burden emphasize the necessity for the implementation of strong tobacco control measures. [ABSTRACT FROM AUTHOR]

This paper uses critical discourse analysis and critical literacy to analyze the first in a series of literacy primers developed with US support for children in Afghanistan in the 1980s, called 'Jihad literacy'. The text is analyzed for its ideological content as related to the themes of religion, violence, and martyrdom in the historical perspective of the Cold War and the Soviet Union's invasion of Afghanistan. The paper demonstrates how the notion of 'Jihad' was subverted to promote a holy war against the Soviet invasion. The educational system supported by the US created a radical version of Islam based on violence and martyrdom, shaping the Afghan society to this day. We contend that the same or similar institutions shape current discourses as in the past and that children are the main victims of politico-economic warfare.

The article comments on the paper by B. Pardo and colleagues about the production of methamphetamine in Afghanistan. Topics discussed include the role of ephedra in the expansion of methamphetamine production in the country, the uncertainty of the Taliban's ban on drug production, and the possible increase in the manufacture of methamphetamine or other synthetic substances using synthetic precursors.

This paper presents the results of the mineralogical, petrographic and chemical study of different archaeological samples related to terracruda sculptures and other elements that were part of the architectural decoration of the Buddhist sites of Tepe Narenj and Qol‐e‐tut (Kabul, Afghanistan; fifth to 11th centuries CE). The main objective of the study was to characterize the samples using an archaeometric approach. The study helped to better understand the materials involved in the modeling of Afghan sculptures and their processing, such as the different nature of the clay layers and the finishing 'stucco' coating. The results further indicate that similarities exist among the manufacturing process of the studied samples and that used today by an ancient caste of clay artists in West Bengal (India), suggesting the existence of a continuous technological tradition that deserves to be further explored in the future. [ABSTRACT FROM AUTHOR]

International studies students are often interested in understanding contexts of conflict and war and working with affected populations. Although various research has assessed different pedagogical tools for increasing students' understanding of war experiences and reducing the perceived distance between such populations, virtual encounters are an understudied means for achieving these aims. This article examines how a US international studies course integrated virtual dialogue sessions with Afghan students to reduce the distance between Americans and Afghans. Accordingly, we conducted pre- and post-surveys and interviews, engaged in participant observation, and analyzed reflection papers to understand how US students' views transformed from the program. We find that American students learned about the precarity and resilience of Afghans and recognized their humanity. Moreover, participants developed outgroup trust, reduced intergroup anxiety, and in some cases developed empathy for the other group. Students experienced these shifts despite technological and logistical challenges, a language barrier, and the power imbalance, which led to ethical concerns for program instructors. Thus, we argue that virtual encounters can be an effective pedagogical tool for reducing distance between international studies students and war-affected populations and helping them to connect across group differences despite the inherent challenges in such programs. [ABSTRACT FROM AUTHOR]

"Snakes and Ladders" is an ancient Indian board game played by the throw of dice or cowrie shells on a grid of labelled squares. It belongs to the category of "race games" and more specifically "promotion games" of moral instruction. The player gradually moves his piece upward from the lower section of vices and hellish states to the higher section of virtues and subtle spiritual states finally to reach the divine realm. Landing on snakes brings him down whereas by reaching ladders the ascent journey is accelerated. As a game of gnosis, Snakes and Ladders was played by Jainas, Hindus, Buddhists as well as Muslims. In Turkey, it is known as satranc-ı urefā and in the Arab world as shaṭranj al-ʿārifīn – "chess of the gnostics." The present paper examines a rare Sufi version from Afghanistan embroidered on cloth also highlighting the imagery of its figural motifs. Building on preceding studies, it focuses on the mystical terminology inscribed onto 101 squares which largely reflects the philosophy of Ibn al-ʿArabī. The investigated cloth-board is an example of Sufi material religion in folkish style which might date from the mid-twentieth century or later and appears to have been used by Shiʿite Sufis. [ABSTRACT FROM AUTHOR]

This paper reports the results of an experiment conducted before the 2021 regime change in Afghanistan that examined how different types of information strategies affected private sector support for a hypothetical peace agreement with the Taliban. We compared the impact of historical, pecuniary, and religious information on the stated preferences of Afghan business elites and employees in Kabul. The results show that historical information had less of an effect than pecuniary information on respondents' probability of accepting a peace agreement with the Taliban but a slightly larger effect than religious information. Although the context of the study has dramatically changed, the findings can inform practitioners and policymakers in mediating future peace negotiations in Afghanistan and elsewhere. [ABSTRACT FROM AUTHOR]

The evaluation of saturated hydraulic conductivity (Ks) constitutes an invaluable tool for the management and protection of groundwater resources. This study attempted to estimate Ks in the shallow aquifer of Kabul City, Afghanistan, in response to the occurring groundwater crisis caused by overexploitation and a lack of an appropriate monitoring system on pumping wells, based on datasets from well drilling logs, various analytical methods for pumping test analyses, and laboratory-based methodologies. The selection of Ks estimation methods was influenced by data availability and various established equations, including Theis, developed by Cooper–Jacob, Kruger, Zamarin, Zunker, Sauerbrei, and Chapuis, and pre-determined Ks values dedicated to well log segments exhibited the highest correlation coefficients, ranging between 60% and 75%, with the real conditions of the phreatic aquifer system with respect to the drawdown rate map. The results successfully obtained local-specific quantitative Ks value ranges for gravel, sand, silt, clay, and conglomerate. The obtained results fall within the high range of Ks classification, ranging from 30.0 to 139.8 m per day (m/d) on average across various calculation methods. This study proved that the combination of pumping test results, predetermined values derived from empirical and laboratory approaches, geological description, and classified soil materials and analyses constitutes reliable Ks values through cost-effective and accessible results compared with conducting expensive tests in arid and semi-arid areas. [ABSTRACT FROM AUTHOR]

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International concern for the human rights of Afghan women has spiked since the Taliban consolidated power in Afghanistan in fall 2021. Yet little is known about how to effectively advocate for women's human rights under this new context. We present findings from a random sample of all adult Afghan internet users' attitudes toward peace, security, gender, and human rights and find significant support for women's human rights as a national priority within Afghanistan, even when controlling for other priorities and even among many men and women aligned with the Taliban. Given that men now have much more political power in Afghan society to protect women's rights, we paid particular attention to men's attitudes toward women's human rights. Our evidence from an embedded survey experiment, building on earlier literature from other countries, demonstrates that fathers of eldest daughters are particularly likely to favor prioritizing women's rights when primed to think about the gender of their eldest children. Thus, the human rights and humanitarian community should spend more time and attention engaging with this demographic, and specifically creating marketing and advocacy strategies that encourage men to think about or act on behalf of their eldest daughters. [ABSTRACT FROM AUTHOR]

Introduction: This study, of significant importance to healthcare professionals, policymakers, researchers, and organizations involved in child healthcare and malnutrition in Afghanistan, aimed to estimate the out‐of‐pocket expenditure (OOPE) in patients under 5 years old with severe malnutrition in a children's hospital in Herat Province, Afghanistan. Method: This study employed a meticulously designed cross‐sectional descriptive‐analytical approach with practical results. The research population consisted of families with malnourished children under 5 who were referred to Herat Children's Hospital. Data was collected using a comprehensive standard World Health Organization questionnaire to gather demographic information from children in Herat. A carefully selected convenience sampling method was used, with 300 referring patients participating in face‐to‐face interviews with the supervisors of these children. After obtaining personal consent and coordinating with health officials, interviews were conducted with the caregivers of children under 5 who suffered from severe malnutrition. The data was then analyzed using robust descriptive statistics, quantitative variables, mean and standard deviation, frequency, and relative frequency. Multiple regression analysis was used to determine the factors that most influenced direct payments from patients' pockets, ensuring the reliability and validity of the findings. Results: The results showed that OOPE in both households with seven and less than seven people and more than seven people was 68%. The findings indicated that among the residents of Herat referred to the studied hospital, these people spent 54% of the treatment costs directly out of pocket. In contrast, people in the rural areas of Herat pay 69% of the treatment costs to receive medical services straight out of pocket. The critical point is that 93% of the families have incurred catastrophic expenses to treat their children suffering from severe malnutrition. The research revealed that the patient's location and the education level of the head of the household were the most significant factors affecting out‐of‐pocket payments by patients. Conclusion: Increasing OOPE in rural Afghanistan poses a significant obstacle to equitable healthcare services and access to appropriate medicines. To support the goal of universal healthcare coverage, geographic imbalances, and broad health financing options must be addressed. Strengthening insurance coverage and more government assistance can significantly reduce these patients' out‐of‐pocket payments. [ABSTRACT FROM AUTHOR]

Prevalent counterinsurgency theories posit that small development aid projects can help stabilize regions in conflict. A widely assumed mechanism runs through citizen attitudes, often called "winning hearts and minds," where aid brings economic benefits and sways public perceptions, leading to more cooperation and, eventually, less violence. Following a preregistered research design, we test this claim using difference‐in‐differences, leveraging original survey data, and new geocoded information about infrastructure projects in northern Afghanistan. We find that aid improves perceived economic conditions but erodes attitudes toward government and improves perceptions of insurgents. These attitudinal effects do not translate into changes in violence or territorial control. Testing mechanisms, we find projects with robust local consultation have fewer negative attitudinal effects, as do health and education projects. These findings challenge the "hearts and minds" theory but complement the wider literature on legitimacy, suggesting that foreign aid can improve human development but rarely meaningfully brings political stabilization. [ABSTRACT FROM AUTHOR]