Afghanistan has one of the highest mother and child mortality rates in the world. Every year, one in ten children dies before the age of five. Every two hours, one Afghan woman dies from pregnancy-related causes. These statistics, from the 2010 Afghan Mortality Survey, are tragic but they do not tell the complete story of healthcare in Afghanistan. There has been significant progress in the sector. More than 60 percent of the population now lives within a one-hour walking distance to the nearest health facility, an increase from nine percent in 2002. Infant mortality has decreased by 57 percent and child mortality by 62 percent. Attendance at birth by a trained provider has more than doubled, leading to substantially lower maternal mortality ratios than previously reported. USAID works on health-related development projects alongside local partners and emphasizes the leadership and management role of Afghan officials.
USAID has adopted a four-pronged approach to improving the health of the Afghan people, especially women and children:
meeting the immediate healthcare needs of the population by supporting the provision of primary healthcare services;
improving the health-related behavior of individuals, families, and communities;
increasing demand for, and access to, quality health products and services through the private sector; and,
addressing the long-term sustainability of the healthcare system by strengthening the capacity of Afghanistan’s Ministry of Public Health (MoPH) at the central and sub-national levels.
MEETING IMMEDIATE HEALTHCARE NEEDS
In partnership with the MoPH, as well as international and Afghan non-governmental organizations (NGOs), USAID supports the delivery of essential health services and pharmaceuticals through 540 health facilities in 13 of the country’s 34 provinces. Services are provided through the Basic Package of Health Services (BPHS) and the Essential Package of Hospital Services (EPHS). On average, nearly one million people per month are treated at USAID-supported health facilities. Of these, 76 percent are women and children younger than five.
USAID supports regular in-service training programs for physicians, nurses, and midwives to ensure quality care. USAID also trains community health workers in order to take healthcare to communities. U.S. government programs have trained nearly half of all volunteer community health workers in Afghanistan.
Increased access to skilled birth attendants is essential to improving maternal and child health. To date, more than 1,800 midwives have graduated from USAID-supported programs, bringing their numbers up to roughly 3,300 trained midwives in Afghanistan, from just 467 during Taliban rule. The welcome result is the increasing use of prenatal care in rural Afghanistan. In 2003, it was an estimated 16 percent; in 2010 it had risen to 60 percent.
USAID also supports tuberculosis detection, treatment, and control efforts in both urban (Kabul) and rural (13 target provinces) settings with the MoPH, using the Directly Observed Therapy Short Course (DOTS) methodology.
BUILDING CAPACITY IN THE HEALTH SYSTEM
USAID provided technical assistance to MoPH to build its financial, procurement and management systems, thereby enabling it to receive direct funding from the U.S. Government. USAID continues to provide technical support to the MoPH to improve its capacity to plan and manage activities, allocate resources, increase human resource capacity, strengthen health information and logistics systems, and monitor and evaluate the BPHS and EPHS programs.
INCREASING ACCESS TO HEALTHCARE THROUGH THE PRIVATE SECTOR
USAID has helped make affordable health products more widely available to the rural, low-income population by expanding private sector distribution of selected socially marketed high-quality contraceptives, oral rehydration salts, and safe water solutions. To disseminate public health messages and educate communities on issues such as the importance of birth spacing and diarrhea prevention and treatment, USAID programs support radio and TV spots, billboards, community health meetings, and mobile cinema. USAID also supports the MoPH in developing effective partnerships with the private sector to facilitate the delivery of quality and financially sustainable health services, particularly in hospitals.
- 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: April 14, 2014