In 2002, Afghanistan had one of the lowest life expectancy rates in the world. Many Afghans did not have access to basic health services, and few women were able to seek healthcare. Today, strong collaboration among the Afghan Government, the U.S. Agency for International Development (USAID), other donors, and Afghan and international non-governmental organizations (NGOs) has led to significant progress in Afghanistan’s health sector.
Afghans, especially mothers and children, have seen dramatic improvements in health and life expectancy:
- In 2013, as a direct result of U.S. Government assistance, over 420,000 pre-birth care visits and 150,000 births were attended by skilled providers.
- The percentage of women receiving care before birth has increased from 16% in 2002 to 60% in 2010, and the percentage of women being attended to by a skilled provider at birth increased from 14% in 2002 to 46% in 2012.
In 2002, only 9 percent of Afghans lived within a one-hour walk of a health facility. Today, more than 57 percent of the population does, enabling Afghans to seek medical attention, consult trained staff, and pick up medicine. Infant mortality has decreased by 53 percent and child mortality by 62 percent. Since 2003, the number of trained midwives present at birth has more than tripled reducing maternal mortality rates. In 2013 alone, more than 150,000 babies were delivered by skilled birth attendants as a direct result of U.S. Government assistance. The World Health Organization reports Afghanistan has made steady progress in recent years combatting polio; the number of cases peaked at 80 in 2011, but has since dropped to 14 in 2013. Even with these improvements, many Afghans still lack access to basic health services. Much work remains to be done, and USAID remains committed to building Afghanistan’s health sector.
USAID works on health-related projects alongside local partners and emphasizes Afghan leadership and management. The USAID approach to improving the health of the Afghan people, especially women and children, is based on four pillars:
- meet the immediate health needs of the Afghan people;
- improve the health behaviors of individuals, families, and communities;
- increase demand for and access to quality products and services through the private sector; and,
- address the long-term sustainability of the healthcare system by strengthening the capacity of the Ministry of Public Health (MoPH) at the national and sub-national levels.
MEETING IMMEDIATE HEALTHCARE NEEDS
In partnership with the MoPH and international and Afghan NGOs, USAID is funding the provision of essential services and medicines at more than 640 health facilities in 13 of Afghanistan’s 34 provinces. This USAID work is part of a donor-coordinated effort to provide essential health services throughout Afghanistan. On average, nearly one million people per month are treated at USAID-supported facilities; of these, 76 percent are women and children younger than five. USAID funds regular trainings for physicians, nurses, and midwives to encourage delivery of quality care. USAID also trains community health workers, so remote and difficult-to-reach communities can have access to medical staff. Afghanistan has more than 25,000 community health workers, and USAID has trained nearly half of them. Increased access to skilled birth attendants is essential to improving maternal and child health, and more than 2,050 midwives have graduated from USAID-supported programs. With the support of USAID and other donors, the number of midwives increased from 467 during Taliban rule to about 4,000 today. As a result, access to prenatal care in rural Afghanistan increased from an estimated 16 percent in 2003 to 60 percent in 2011.
USAID is also seeking to address the prevention and treatment of chronic malnutrition through projects that strengthen community resiliency and Afghan Government interventions. Given the high incidence and prevalence of tuberculosis (TB) in Afghanistan, USAID also supports detection, treatment, and control efforts. In 2012, the Directly Observed Treatment Short-course program, which ensures a patient adheres to standard, daily TB treatments, had a 91% success rate.
BUILDING CAPACITY IN THE HEALTH SYSTEM
USAID has provided capacity-building support to the MoPH to enhance its financial, procurement, and management sys-tems. USAID continues to work with the Ministry to improve its ability to plan and manage activities, allocate resources, increase human resource capacity, strengthen health information and logistics systems, and monitor and evaluate pro-grams. This capacity-building assistance strengthens the Ministry as an institution and builds responsible, accountable, and transparent processes, so it remains eligible to receive U.S. Government funding to implement specific programs.
INCREASING ACCESS TO HEALTHCARE THROUGH THE PRIVATE SECTOR
USAID helped make affordable health products more widely available to rural, low-income populations by expanding pri-vate-sector distribution of selected socially marketed, high-quality contraceptives, 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.
- Central Contraceptive Procurement (CCP)
- Disease Early Warning System (DEWS)
- Health Care Improvement (HCI) Project
- Health Policy Project (HPP)
- Health Services Delivery Grant - Partnership Contracts for Health (PCH)
- Health Services Delivery Grant - Performance-based Partnership Grants (PPG)
- Leadership, Management, Governance (LMG)
- Routine Immunization in Afghanistan
- Strengthening Pharmaceutical Systems (SPS)
- TB CARE 1
- USAID|DELIVER Project
- Basic Support for Institutionalizing Child Survival-III (BASICS-III)
- Better Health for Afghan Mothers and Children Project
- Child Protection and Psychological Support for Afghan Children and Youth Program/Assistance for Afghanistan’s Most Vulnerable Children
- Child Survival Support Grant: Better Health for Afghan Mothers and Children Project
- Communication for Behavior Change: Expanding Access to Private Sector Health Products and Services in Afghanistan (COMPRI-A)
- Comprehensive Disabled Afghans Program/National Program of Action on Disability
- Field Epidemiology and Laboratory Training Program (FELTP)
- Health Research Challenge for Impact: Reproductive Age Mortality Survey (RAMOS) II
- Health Service Support Project (HSSP)
- Health Systems 20/20
- Higher Education Project: Kabul Medical University
- Measure DHS: Afghanistan Mortality Study
- Rural Expansion of Afghanistan's Community-based Healthcare (REACH)
- Technical Support to the Central and Provincial Ministry of Public Health (Tech-Serve)
- Tuberculosis Control Assistance Program (TB CAP)
- UNICEF Health and Immunization Response Support
- UNICEF Nutrition Program in Afghanistan
- UNICEF Salt Iodization in Afghanistan
- WHO Cross Border Malaria Program
- WHO TB
Last updated: September 10, 2014