INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSISISSN(print): 2643-9840, ISSN(online): 2643-9875
Volume 07 Issue 06 June 2024
DOI: 10.47191/ijmra/v7-i06-40, Impact Factor: 8.22
Page No. 2723-2731

Investigation into the Mental Health of Businesswomen in
Afghanistan after August 2021
Tayeba Hashemy1, Fatema Rezaei1, Rajeev Shrestha2, Sayed Mahdi Hashemy1, Yasuhiro
Kotera3, Yudai Kaneda4, Divya Bhandari5, Akihiko Ozaki5,6, Gholam Mohammad Amiri1, Sayed
Hamid Mousavi1
1

Department of Health Economics, Afghanistan National Charity Organization for Special Diseases, Kabul, Afghanistan
Department of Pharmacy, District Hospital Lamjung, Besisahar, Province Gandaki, Nepal
3
School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
4School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
5
Medical Governance Research Institute, Tokyo, Japan
6
Department of Breast Surgery, Jyoban Hosptial of Tokiwa Foundation, Fukushima, Japan
2

ABSTRACT: The shift of power to the Taliban had negatively affected the mental health of businesswomen due to the current
restrictions on women. Therefore, this study aimed to evaluate the experience of mental health issues among businesswomen in
Afghanistan after the Taliban came to power. We examined the mental health challenges they faced, what helped deal with them,and what might be helpful and effective in supporting the mental health of Afghan businesswomen in the future. In-depth semistructured interviews were conducted from February 17, 2022, to February 29, 2022, with 14 businesswomen (Owner/CEO) basedin Kabul, Herat, Mazar-e-Sharif, Kandahar, and Jalalabad. Data were analysed using thematic analysis appraising businesswomen's
mental health experiences and coping strategies.
Four themes were identified: Theme 1: Stress and anxiety, Theme 2: Restrictions as to the main source of stress and anxiety,
Theme 3: Courage to work and religious beliefs as coping strategies to relieve their stress, and Them 4: Support and ease ofrestriction can be effective to businesswomen's mental health wellbeing. The study concluded that the mental health ofbusinesswomen was affected as the Taliban took control of the government. Participants reported increased stress and anxiety
levels, based mainly on restrictions imposed on women after the Taliban came to power. The most helpful coping strategy was
self-motivation to continue their businesses. They also reported a need for financial and technical support. Our findings can help
the government and organizations that support women and their economic activities to identify effective measures to support
businesswomen in challenging times.
KEYWORDS: Afghanistan, Businesswomen, Mental health.
1. INTRODUCTION
Afghanistan has been embroiled in war and terrorist attacks for many years, and people have witnessed violence, war wounds,
loss of loved ones, and displacement inside the country [1,2]. These events have negatively impacted the mental health of civilians[3]. Remarkably, between 1996 and 2001, when the Taliban was in power and ruled Afghanistan for five years, the mental healthof the public was significantly impacted [1,4]. During that time, women experienced very restrictive regulations that prevented
them from accessing their fundamental rights such as education, health care, and work outside the home [5]. However, since2001, many efforts have been made by Government and international communities to provide education, health care, and workoutside the home facilities for women [6]. After this shift, women were trained to recognize their rights, entered the job market,
and chose a career of their interest, and some of them entered the business market and started many ventures [7]. According to
the latest report, 22.76% of women joined the labor market in 2020 [8]. However, since the Taliban again came to power in 2021
(August 15), many reports have claimed severe violations of women’s rights and unjust restrictions [9 - 11]. For example, theTaliban recently banned women from showing their faces on media [12, 13]. Which these restrictions can effect on women’s
mental health. In this regard, during COVID-19, the World Health Organization (WHO) reported that this pandemic had an impact

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Investigation into the mental health of businesswomen in Afghanistan under the Talibanon the mental health of the population due to the stress caused by the movement restrictions in Afghanistan, while generally;
women are more exposed to the mental issues [14, 15]. Currently, the Taliban have imposed strict limitation on the female
generation, limiting their ability to work outside the home. This limitation coupled with the consequences of COVID-19 pandemic;
Afghan women today are at the greater risk of developing mental health problems than ever before [16, 17]. However, thenegative impact of these restrictions and financial stress on the mental health of businesswomen has not been explicitly reported.
Therefore, our study aimed to assess i) psychological challenges faced by the businesswomen residing in Kabul, Herat, Mazar-eSharif, Kandahar, and Jalalabad, ii) coping strategies used to deal with such challenges, and iii) kind of support that are needed toenhance their mental wellbeing.
2. METHODS
Study design: Thematic analysis of semi-structured interviews was conducted among 14 businesswomen (Owners / Chief
Executive Officers [CEO] of a company) from February 17, 2022, to February 29, 2022.
Study sample and setting: Participants were purposively
recruited. Initial announcements regarding the study were
provided to 43 individuals in 5 provinces (Kabul, Kandahar,
Jalalabad, Mazar-e-Sharif, and Herat) by telephone, and they
were invited to participate in the interview. Among them, 27
women refused to join due to the security problems in theircities. 16 women accepted to participate in the interview.
However, later, 2 of them withdrew from the interview whichaccording to the ethical guideline we did not ask for the reasonof their withdrawal. The remaining 14 participated. They wereselected from 5 provinces (Kabul, Kandahar, Jalalabad, Mazare-Sharif, and Herat) of Afghanistan, representing 5 different
geographical zones of Afghanistan (Figure 1).

Figure 1: Selected provinces of different geographical zones

The participants were selected from IT services, handicrafts, food processing, apparel, and agriculture sectors. The eligibility
criteria for participation were (a) business owner working as the CEO of a company at the time of Taliban governance (From August2021 to February 2022 was working) and (b) being present in the country during the same period.
Ethical review and informed concerned: Ethical approval was obtained from the Human Research Ethics Committee of the
Afghanistan National Charity Organization for Special Diseases (ANCOSD), Kabul, Afghanistan (AF, ANCOSD, HREC, 08, 12/02/2022)
before data collection. All the invited participants were informed verbally regarding the study, and their verbal consent was sought
before conducting an interview.
Instrument: Interview questions were developed by studying a similar mental health study that explored the challenges, coping
strategies, and future thoughts [18]. The questions were divided into three parts. The first part contained three questions about
interviewees (age, education, and experience), the second part contained three questions about their businesses (province, sector,
and company size), and the third part contained 5 questions and addressed the main questions of the study, which are as following:
Q1: How do you feel mentally in the current situation as a businesswoman?
Q2: What are your main stressors in the current situation?
Q3: How do you cope with those stressors or difficulties? What do you find helpful?
Q4: What do you think you need to better cope with your mental health difficulties?
Q5: What needs to change for businesswomen in Afghanistan to have good mental health?
With these questions, we examined the specific psychological challenges that businesswomen faced (Q1, Q2), what helped deal
with mental health problems (Q3), and what might be helpful and effective in supporting the mental health of these women in
the future (Q4, Q5).
Data collection procedure and analysis: All the participants were informed regarding the study, and their consent was sought
verbally before conducting an interview. We used a semi-structured interview to gather accurate information and allow
participants to express their feelings and thoughts. Prior to the interview, all participants received the interview questions. Dueto the physical distance, all interviews were conducted by telephone. Interviews were conducted in February 2022 and recorded
by TH and each interview took approximately 15 minutes. All participants only knew about TH that TH is a female mental health

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Investigation into the mental health of businesswomen in Afghanistan under the Taliban
researcher in Afghanistan. SMH transcribed each interview verbatim in Dari and Pashto separately, then sent it to the participants,
which they verified. TH translated them into English and rechecked them twice by TH and DB. Then, DB conducted an in-depth
data analysis thematically using Braun and Clarke’s 6 steps [19].
1) Familiarization: Interview notes were read repeatedly by DB and TH to understand the entire data and figure out thepossible patterns.
2) Generating Initial Codes: Coding was conducted through each questionnaire separately. DB coded each segment thatwas relevant and interesting to the research questions. 194 codes were generated, such as: “loss of independence”,“uncertainty”, “fear”, “severe emotional shock”, “cannot give up”, “decided to accept all hardship”, “trust God”,“financial support”, “self-motivation”, “negative effect on the psyche” etc.
3) Searching for Themes: To organize the codes into themes, researchers used mind-mapping methods to display all thecodes altogether and see all the codes simultaneously to develop themes freely. The 194 codes were grouped into four
themes which were: “stress and anxiety”, “restrictions as the main source of stress and anxiety”, “courage to work andreligious beliefs as coping strategies to relieve their stress”, and “support can be effective to businesswomen’s mental
health wellbeing”.
4) Reviewing themes: Researchers reviewed the four themes by comparing them with the codes to ensure independent
coherence between each code and theme. Finally, the data were organized to address our research questions.
5) Defining and naming themes: Next, the collated data were reviewed once again to ensure that the wording of eachtheme represents the meaning and responds to our research questions [Table 1]:
Table 1: Developed themes and research questions
S.N. Theme
Research Question
1
2
3

4

Stress and anxiety
Restrictions as the main source of stress andanxiety
Courage to work and religious believe as
coping strategies to relief their stressSupport and ease of restriction can beeffective to businesswomen’s mental healthwellbeing-

How do you feel mentally in the current situation as a businesswoman? (Q1)-

What are your main stressors in the current situation? (Q2)-

How do you cope with those stressors or difficulties? What do you findhelpful? (Q3)
What do you think you need in order to better cope with your mental healthdifficulties? (Q4)
What needs to change, in order for businesswomen in Afghanistan to havegood mental health? (Q5)-This article addresses the last step 6) Reporting.
3. RESULT
Demographic Characteristics: Table 2 provides the demographic details of the 14 interviewees (Owner/CEO of women-owned
companies). The majority of the participants (64.3%; N=9) were 30 years old or higher and had a bachelor's degree (42.8%; N=6)
with experience of 3 years or higher (58.2%; N=8) [Table 2].
Table 2: Demographic Characteristics of Participants (Businesswoman) [N=14]
Characteristics
Categories
Age

Education

Experienceasbusinesswoman

a

<30
>30
Primary
SecondaryIntermediate level (12 Grade)
Bachelor
Master<3>3

N (%)
9 (64.3%)
5 (35.7%)
2 (14.2%)
3 (21.5%)
2 (14.2%)
6 (42.8%)
1 (7.1%)6 (42.8%)
8 (58.2%)

Table 3 shows the demographic details of the companies the participants worked for (N=14). Most of the companies were locatedin Kabul (35.9%; N=5), operating in handicraft sectors (43.0%; N=6), and were small-size with 5-19 employees (57.2%; N=8) [Table
3].

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Investigation into the mental health of businesswomen in Afghanistan under the Taliban
Table 3: Demographic Characteristics of participants companies [N=14]
Characteristics
Categories

SectorCompany Size

Province

IT Services
Handicraft
Education
Food Processing
ApparelAgriculture
Small (Minimum 5 employees)
Medium (Minimum 20 employees)
Large (Minimum 50 employees)
Kabul
Mazar-e-Sharif
Kandahar
Jalalabad
Herat

N (%)
1 (7.1%)6 (43.0%)
1 (7.1%)
3 (21.5%)
2 (14.2%)
1 (7.1%)8 (57.2%)
4 (28.6%)
2 (14.2%)
5 (35.9%)
3 (21.5%)
2 (14.2%)
2 (14.2%)
2 (14.2%)

Themes: Regarding the main questions, 4 themes were identified: Theme 1 (T1) Stress and anxiety, T2 Restrictions is the primarysource of stress and anxiety, T3 Courage to work and religious beliefs as coping strategies to relieve their stress and T4 Supportand ease of restriction can be effective to businesswomen’s mental health wellbeing.
T1: Stress and anxiety consider that businesswomen experience high levels of stress and anxiety due to the uncertain future andthe current situation regarding their primary rights, including economic activities. T2: Restrictions regarding the primary source ofstress and anxiety indicate their stressors and concerns about the impact and consequences of restriction on their economic
activities (Business). T3: Courage to work and religious beliefs as coping strategies to relieve their stress considers the coping
strategy of businesswomen regarding stress and anxiety after the Taliban came to power. Lastly, T4: Support and ease of restriction
can be practical to businesswomen’s mental health wellbeing highlighted the way that will help these women to deal with theirstress and anxiety.
Theme 1: Stress and anxiety
All participants reported that their stress and anxiety increased with the arrival of the Taliban in government. Their reasons forstress were the uncertainty of the future, financial instability, and fear of being dependent financially.
Participant (5): The situation is clear to everyone, and I am sure that in these 6 months (August 2021 to February 2022), there
will be no one who has been able to experience a calm situation… additionally, no specific rules or procedures forbusinesswomen have yet been issued by the government, and we are in a state of confusion.
Participant (9): When the Taliban came to power; women completely lost their independence, which negatively impacted
their mental health. Unfortunately, the working women have now settled down at home, affecting their mental health. I'mvery frustrated right now.
Participant (10): Our nerves are not comfortable. We feel confused. I do not understand anything at all… I'm very worried
about the current situation and my future in Afghanistan.
Participant (12): We are very disappointed because our work was our source of income. Unfortunately, we are now back tosame situation when we were just starting a few years ago. It is tough for us to bear this situation.
On the other side, participants reported that stress and anxiety affected not only their business activities but also their personal
life.
Participant (10): Sometimes, I cannot even manage my personal life due to the stress.
Participant (9): My employees experienced a high-stress level which, in some cases, has led to a marital or relational conflict.
It has also caused women to become tense and aggressive with their children.
Some participants whose production volume was not reduced significantly reported that their stress level had decreased a little
since the situation was almost the same in the last 6 months.
Participant (3): In the beginning, when the Taliban came to power, we were disappointed because of the terrible situation…,
now as we were not forced to close our business, this frustration has diminished, although we are still not convinced by the
Taliban that women can continue their economic activities and we have our stress.
Participants' responses confirmed the experience of their stress, suffering, and anxiety on the rise of Taliban in government;
however, some have started to habituate to the situation as the challenges have not been settled over time.

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Investigation into the mental health of businesswomen in Afghanistan under the Taliban
Theme 2: Restrictions as the main source of stress and anxiety
All participants reported that they had faced several restrictions that prevented them from resuming their business activities as
before (Before August 2021) and caused experience of high stress and anxiety. These included women's insecurity,
staying/working from home, inability to access the market, and inability to hire female staff and do their modeling activities in thehandicraft sector.
Participant (1): We are not mentally ready to start our work as before and continue it with peace of mind.
Participant (2): We used to work extensively on which models worked with us, but now neither the model is willing to workwith us nor can we afford it. That is why we cannot advertise our products... Although some say that the restriction is not at
a high level, in my opinion, the restriction does not exceed this. If a woman goes to the streets to ask for her right, she will be
imprisoned.
Participant (6): There is no guarantee for women to access their labor rights. There have been many changes in our work
process, we cannot go to work ourselves, and women who used to work with us in the field cannot work with us now.
Participant (10): I used to be a leader for more than 1,500 employees, but now I stay at home due to the restriction of the
Taliban.
Moreover, some of the participants reported that not even the restrictions but the fear of restrictions that women will be facedin the future negatively affected their mental health.
Participant (8): One of the leading causes of stress is our government (Taliban) itself. It has created a fear among the women.
When we work, there is the same fear, and we are afraid that something bad will happen to us.
In general, Restrictive actions and lack of positive women-friendly acts and government policies potentiate the stressful effect on
them.
Theme 3: Courage to work and religious believe as coping strategies to relief their stressSome participants reported that self-motivation and resuming their business activities would help them to be mentally relaxed,which was supported by providing jobs for other female employees.
Participant (1): Instead of sitting down, I prefer to look for ways to reactivate my company. This allows me to feel somewhat
comfortable emotionally.
Participant (4): When I think about my business and my ability that I can do something for women to earn money, it motivates
me not to give up.
Participant (14): we have to work as much as possible. As soon as we think we can participate in the development of ourcountry, it enables us to work and face disappointments.
Additionally, some participants reported that their religious beliefs help them cope with mental pressure and difficulties.
Participant (8): First, we trust God and hope we can work again. Secondly, in my opinion, a businesswoman never falls because
she accepts all the risks and enters the business.
In general, these women reported that resuming their work with their religious beliefs and self-motivation helped them relieve
their stress and anxiety a little, which showed these are what they could do during this period (August 2021 to February 2022).
Theme 4: Support and ease of restriction can be effective to businesswomen’s mental health wellbeing
Participants reported that the financial support of international organizations/communities is an emergency need for resuming
their business activities.
Participant (8): Businesswomen suffered severe financial losses. We need the financial support of internationalorganizations/communities to balance these losses and continue our business activities.
Participant (13): We do not need food. We need money to run our businesses then we can make income for our staff, andthey can spend it where we need. Not all homes are rent-free.
Participant (11): The Taliban must make it possible for women to work in all sectors, such as culture, politics, society, and theeconomy. Organizations working for the growth and development of women must be allowed to operate in the country andsupport women-owned businesses. Opportunities must be created for women to work equally with men.
In addition, participants reported that ease of restriction within the country by the government (Taliban) could help them to bewell mentally.
Participant (1): The new government should provide working conditions for businesswomen so they can easily continue theirbusiness without fear or worry.
Participant (4): The imposition of some restrictions on women must change so that these women can work freely.

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Investigation into the mental health of businesswomen in Afghanistan under the Taliban
In general, businesswomen reported that ease of restriction (receiving their rights), financial support, and ensuring safety would
help to relieve their stress and improve their mental health. Women’s abilities, beliefs, and the discriminatory environment, where
they used to work, help them cope with the difficulties and distress.
4. DISCUSSION
This study aimed to explore the experiences of businesswomen regarding their mental health issues under the Taliban
governance (August 2021 – February 2022). Participants reported that their stress and anxiety levels increased during this period,
while the primary stressor was restricting their activities out of home (Business activities). They managed their stress level to someextent using adopted coping strategies such as self-motivation, faith in God, etc. Ease of restriction and support from internationalorganizations were highlighted as essential factors in resolving the current problem and eventually promoting their mental wellbeing.
After the rise of the Taliban to power, the businesswomen reported suffering from mental distress such as stress and anxiety (T1).
Although Saboor et al. and Shoiba et al. had reported that Afghan women are experiencing relatively higher mental healthproblems under the Taliban [11, 20], examining the mental health of businesswomen is an important issue that requires serious
attention due to the restrictions on women's economic activities, as working women are more exposed to mental problems thanothers (housewives) [21]. These mental problems (Stress) have multidimensional adverse effects on their dimension (family
relationships), organizational size (productivity and performance), and an economic dimension (level of household poverty andeven economic growth) [22, 23, 24-25]. There is a possibility that these effects be more severe for Afghan businesswomen under
the Taliban and their opinion about women and their legal rights. Nowadays, we witness restrictions on education, work, andclothing of women. On other hand, the Taliban Government has not issued any specific policy or regulation for women’s businessactivities. Therefore, it will draw an uncertain and insecure future for businesswomen, resulting in their business closure andfinancial dependence of women who made an income for their families. This is while, some participants also mentioned that they
temporarily stopped working and stayed at home. Although the Taliban have stated that women will stay at home temporarily,
there is a concern that women staying at home may be used as a strategy to exclude women from society [26, 27]. Because when
the Taliban was in power 20 years ago (1996-2001), women experienced a period of deprivation, such as a lack of access to
education, employment, and social and political participation [5].
As the Taliban re-emerged in governance power of the country, the violence against women in the form of restriction to women’s
freedom was also increased. While restriction was mentioned as the primary stressor by the participants (T2), the imposition of
restrictions on women has made working conditions difficult for them. For example, in the handicraft sector, companies cannot
advertise their product using models, which harms their sales volume while they do not have many alternatives to make money.
Meanwhile, removing women workers from the workplace has raised serious concerns about the country's economic situation,such as GDP off by 5% and cost companies more than 1 billion dollars [28, 29]. Which restriction on women and removing themfrom work has been mentioned as a concern by the international communities [30].
However, to cope with the high-stress level, these women tried to continue their work with trust in God (Religious belief) and insome way used their self-motivation strategy as an emergency option. Trust in God belongs to their religious believers, and it
works as a method of self-motivation. Since self-motivation is the internal drive to keep moving forward in a company, it isgenerally assumed to impact employees' performance and satisfaction significantly [31]. Some participants reported that it was
helpful for them and could reduce their stress level but not completely (T3). In contrast, the number of restrictions on women isincreasing. Here, on one side, the sample shows that women were better able to cope with the reduction of stress caused by work
crises by using the routine method of self-motivation (For example, I can, I should not be disappointed). At the same time, mostof them were unfamiliar with self-motivation methods. On the other side, self-determination theory holds that intrinsic motivation
is associated with higher well-being, while extrinsic motivation is associated with lower well-being [32]. Altogether, there is apossibility that self-motivation skills can be one of the most critical factors that can help these women to cope with stress levels.
Moreover, it would be valuable to examine the impact of self-motivation methods (Training) in future research.
Now, in these difficult situations, where coping strategies were limited (T3), these women identified ease of restriction (Which
were mentioned as the primary source of their mental problems) and support of international communities to advance theirbusiness as valuable sources of mental health well-being (T4).
As restriction is the primary stressor for businesswomen who cannot do their businesses freely, ease of restriction may help themto get mental well-being. Moreover, it is noteworthy that businesswomen received numerous supports from internationalorganizations to continue their businesses and, in the current situation; do not have access to financial and non-financial support.
Therefore, participants believe that support from international organizations can help reduce their business problems and mental
issues.

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Investigation into the mental health of businesswomen in Afghanistan under the Taliban
5. STRENGTH AND LIMITATIONThis was the first study that highlighted the mental problems and needs for the mental well-being of businesswomen working
as entrepreneurs and took part in Afghanistan under significant restrictions on women's economic activities. Findings indicate aclear picture of businesswomen's mental situation, which will help recover these women's financial losses with support. Although
this research provides valuable findings, it still carries some limitations. First, our sample relied on a small number ofbusinesswomen who agreed to be interviewed, and most of those invited for interviews refused to participate due to fears about
the situation in Afghanistan for women. Therefore, the studied sample was at its minimum size. Second, due to the lack ofwidespread access to businesswomen in all provinces, the sample included only 5 provinces in 5 different zones. However, the 5provinces included in this study are major and large cities in the country where most businesswomen work. Third, the Taliban's
dominance of the government and their uncertain approach to women is still ongoing, so this study does not cover their postinterview mental health. Fourth, as this research needed multiple researchers with different educational backgrounds, there willbe the possibility of researcher biases caused by the positionality of the researchers. Nevertheless, the findings are of interest toorganizations that support women and their outcomes and provide an assessment of the mental health status of Afghan women
during the period of Taliban control.
6. CONCLUSION
The mental health of businesswomen was affected by the Taliban's takeover of the government. This qualitative study
evaluated the experiences of businesswomen in Afghanistan concerning mental health and coping strategies. Our participants
reported increased stress and anxiety levels, primarily based on restrictions imposed on women after the Taliban took over thecountry. The most helpful coping strategy was self-motivation to continue their businesses. They also highlighted a need forfinancial and technical support. Our findings can help inform the government and Afghan organizations to support businesswomenin the current challenges and future.
ACKNOWLEDGEMENT
We are deeply thankful of all business women in Afghanistan who are strongly trying for independency of women all over thecountry.
DECLARATION OF INTEREST STATEMENT
All authors confirmed that they do not have any interest conflict.
DATA AVAILABILITY STATEMENT
The data for this manuscript was collected by the team of researcher and it will be provided based on the request.
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Investigation into the mental health of businesswomen in Afghanistan under the Taliban
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