Evaluation of Health Promotion Activities in Beauty Parlors in Kabul

Title: Evaluation of Health Promotion Activities in Beauty Parlors in Kabul
Principal Investigators: Marianne El-Khoury and Tess Shiras
Timeline: January 2018-December 2019


Despite improvements in recent years, Afghanistan has some of the world’s worst health outcomes: 1 in every 77 live births results in maternal death, 1 in every 18 children dies before their 5th birthday, only 23% of women use modern contraception, and up to 44 percent of pregnant women suffer from anemia. In Afghanistan, SHOPS Plus supports the Afghanistan Social Marketing Organization (ASMO) to increase access to health information and life-saving maternal, child, and family planning products. Given women’s limited access to public spaces in Afghanistan, SHOPS Plus and ASMO piloted an intervention in Kabul to train beauty parlor staff to conduct information, education, and communication activities related to key family planning and maternal and child health topics. Similar health interventions in countries such as Zambia and the United States have successfully improved health outcomes. To our knowledge, this was the first beauty parlor intervention on child health topics, the first in a conflict setting, and one of very few to be rigorously evaluated.

Research questions:

  • What are the knowledge, attitudes, and practices of beauty parlor clients related to family planning and maternal and child health? 
  • What are challenges and opportunities with program implementation? 
  • What is the impact of the program on women’s knowledge, attitudes, discussions with their spouses, and practices? 

The study was a mixed-method study with a randomized controlled trial (RCT) design. Study components included:

  • A quantitative baseline survey with female beauty parlor clients to measure knowledge, attitudes, and practices of clients on family planning and maternal and child health topics covered in the intervention and inform pilot training and design.
  • Qualitative in-depth interviews and focus group discussions with beauty parlor owners and staff at two intervention mid-points, that will create a feedback loop to inform continued adaptation of the intervention.
  • A quantitative endline survey of beauty parlor clients after the intervention to evaluate the impact of the pilot on clients’ health knowledge, attitudes, and practices.

ASMO and SHOPS Plus used the results to improve the intervention and explore future scale-up of the intervention to other urban areas in Afghanistan and potential replicability in other similar settings.

Relevant Resources

Status: Complete
Last updated: August 2020 

Learn more about our work in Afghanistan, family planning, child health, and pharmaceutical partnerships and social marketing.

See other SHOPS plus studies. 



Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.

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