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Health

A health worker sits with a patient to assess what’s the best course of action.
A health worker sits with a patient to assess what’s the best course of action. USAID works to deliver high-impact health care to families in both rural and urban areas.
USAID/Afghanistan

In 2002, many Afghans did not have access to basic health services, and few women were able to seek health care. Collaboration among the Afghan government, USAID, other donors, and non-governmental organizations has led to significant progress in Afghanistan’s health sector. According to the 2007-2008 Afghanistan National Risk and Vulnerability Assessment, more than 57 percent of the population live within a one-hour walk to a health facility, up from 9 percent in 2002, enabling more Afghans than ever before to seek medical attention, consult trained staff and pick up medicine. The under-five mortality rate has also decreased from 87 per 1,000 live births in 2005 to 55 per 1,000 in 2015, according to the 2015 Afghanistan Demographic and Health Survey (AfDHS). The AfDHS also reports that 51 percent of all deliveries are assisted by a skilled provider.

Even with these improvements, many Afghans still live too far to regularly access basic health services and locate more advanced medical treatment. Much work remains to be done, and USAID is committed to helping Afghanistan strengthen the country’s health sector.

OUR WORK

USAID partners with the Afghan Ministry of Public Health (MoPH) and local partners to make basic health care services accessible to Afghans across the country, especially women and children, by focusing on four pillars:

  • Ending preventable maternal and newborn deaths by introducing and expanding access to basic health services and reducing chronic childhood malnutrition;
  • Empowering Afghans with health knowledge to improve the health behaviors of individuals, families, and communities;
  • Focusing on primary and community health care to increase demand for and access to quality products and services through the private sector; and,
  • Equipping the health system with the skills needed to manage a sustainable nationwide healthcare system, including human resources, financing, information systems and pharmaceutical management at the national and sub-national levels.

RECENT HIGHLIGHTS

  • The MoPH and the Central Statistics Organization (CSO) released the 2015 Afghanistan Demographic and Health Survey (AfDHS), the first nationally representative demographic and health survey ever conducted in Afghanistan, supported by USAID
  • USAID supported the establishment of the National Data Warehouse, a web-based system for storing and sharing public sector health data with stakeholders and policymakers to improve organizational use of data for effective planning, decision-making, and tracking of health programs
  • In 2016, USAID launched a flagship nutrition project to reduce malnutrition and increase access to safe water and sanitation
  • USAID is ensuring close to a million girls receive weekly iron folic acid supplements to prevent anemia
  • USAID is improving the quality of health services in World Bank-supported facilities by helping a cohort of 503 technical trainers to carry out baseline assessments of the quality of care in 23 target provinces

SAVING THE LIVES OF WOMEN AND CHILDREN

In partnership with the MoPH, USAID and other donors support the delivery of the Basic Package of Health Services (BPHS) and the Essential Package of Hospital Services (EPHS) across all 34 provinces of the country. USAID and other international donor support ensures on average, nearly four million people per month are treated at public health facilities. USAID supports regular trainings for physicians, nurses, and midwives to encourage delivery of quality care. USAID trained more than 12,000 community health workers, so remote and difficult-to-reach communities can have access to medical staff and USAID and international donors continue to support the training of community health workers through the World Bank.

Skilled birth attendants and basic pharmaceuticals are essential to improving the health of mothers and their children. More than 2,000 midwives have graduated from USAID-supported programs in cooperation with the MoPH. With the support of USAID and other donors, the number of midwives increased seven-fold from 467 during Taliban rule, according to the 2002 MoPH National Health Resources Assessment, to over 3,000 as of 2011, according to the Afghanistan Mortality Survey. As a result, over half of women (58.6 percent) who had a live birth in the five years preceding the AfDHS, received antenatal care from a skilled-provider, and 87 percent of health facilities have at least one female health worker, according to the MoPH. USAID also supports getting basic pharmaceuticals which can save lives to pregnant women and new mothers.

USAID is preventing and treating chronic malnutrition by training health workers on how to keep their communities healthy. USAID is improving access to water, sanitation and hygiene, promoting dietary diversification, training households on home gardening, home based food fortification and improving the capacity of the government to plan, implement and evaluate nutrition related activities. To date, 2.5 million children under-5 have received nutritional supplements to combat stunting and malnourishment.

With USAID support, the World Health Organization (WHO) expanded the Disease Early Warning System (DEWS) from 300 to over 550 health facilities, which supports the early detection and response to infectious disease outbreaks. Given the high incidence and prevalence of tuberculosis (TB) in Afghanistan, USAID also supports detection, treatment, and control efforts. USAID led the assessment to determine the scale-up feasibility of short-term anti-TB drug regimen for multi-drug resistant TB patients in public health facilities. In 2016, joint efforts between the National Tuberculosis Program and partners resulted in a 19 percent increase in notified TB cases compared to 2015.

ENHANCING THE EFFECTIVENESS AND ACCOUNTABILITY OF THE HEALTH SYSTEM

USAID continues to assist the MoPH in its efforts to plan and manage activities, allocate resources, enhance health information and logistics systems, and monitor and evaluate programs. Since 2004, USAID has supported the implementation of the first phase of a consolidated national health information system, which collects health data countrywide and streamlines multiple antiquated data systems. This assistance strengthens the Ministry as an institution and builds responsible, accountable, and transparent processes.

USAID is improving the quantity and quality of the medicines available in Afghanistan by supporting the creation of the country’s first Essential Medicines List and Licensed Medicines List and revising the National Medicine Policy to meet international standards. The MoPH also endorsed the establishment of a supply distribution chains and registration system for pharmaceutical products. USAID also improved the computerized Pharmaceutical Management Information System database in the General Directorate of Pharmaceutical Affairs.

In 2016 with USAID and international donor support, the MoPH invited the Independent Joint Anti-Corruption Monitoring and Evaluation Committee (MEC) to conduct an evaluation of the MoPH, to develop a code of conduct to establish clear standards in the execution of duties and to institute an Independent Ombudsperson to elevate issues and disseminate strategies. It comprises international and Afghan anti-corruption experts.

INCREASING ACCESS TO BASIC HEALTH SERVICES

USAID helps make essential health services more widely available to rural, low-income populations by expanding private sector distribution of selected pharmaceuticals, oral-rehydration salts, and safe-water solutions. To disseminate public-health messages, such as the importance of birth spacing and diarrhea prevention, USAID programs support radio and TV spots, billboards, community meetings, and mobile cinema. USAID supports the MoPH in developing effective private-sector partnerships to facilitate the delivery of quality, financially sustainable health services.

Current Projects:

Completed Projects:

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