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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 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 2015, as a direct result of U.S. Government assistance, over 560,000 pre-birth care visits and 290,000 births were attended by skilled providers.
- The 2015 Afghanistan Demographic and Health Survey found that infant and child mortality has decreased since 2002, indicating that health interventions are working.
In 2002, only nine percent of Afghans lived within a one-hour walk of a health facility. Since 2008, more than 57 percent of the population lives with a one-hour walk, according to the 2007-2008 Afghanistan National Risk and Vulnerability Assessment, enabling Afghans to seek medical attention, consult trained staff and pick up medicine. The under-five mortality rate has decreased from 87 per 1000 live births in 2005 to 55 in 2015, measured for the 5-year period before the 2015 Afghanistan Demographic and Health Survey (AfDHS). As of 2013, 39 percent of babies were delivered by skilled birth attendants according to UNICEF’s 2015 State of the World’s Children report, in 2010 this figure was calculated at 14%. 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, according to the Global Polio Eradication Initiative, to 20 in 2015. Even with these improvements, many Afghans still lack access to basic health services. Much work remains to be done, and USAID is committed to the work to help build Afghanistan’s health sector.
USAID partners with the Afghan Ministry of Public Health (MoPH) and local partners to improve the health of the Afghan people, especially women and children, by focusing on four pillars:
- Saving the lives of women and children by meeting the immediate health needs of the Afghan people;
- Empowering Afghans with health knowledge to improve the health behaviors of individuals, families, and communities;
- Focus on primary and community health to increase demand for and access to quality products and services through the private sector; and,
- Building capacity in the health system to address the long-term sustainability of the healthcare system by strengthening the capacity of the MoPH at the national and sub-national levels.
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 support, on average, ensures nearly one million people per month are treated at public facilities, of which 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 20,000 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 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 to over 3,000 as of 2011. As a result, over half of women (58.6%) who had a live birth in the five years preceding the AfDHS received antenatal care from a skilled provider.
USAID is also seeking to address the prevention and treatment of chronic malnutrition by training community health workers on preventive and therapeutic nutrition services. improving access to water, sanitation and hygiene, promoting dietary diversification, training women on home gardening, home based food fortification and improving the capacity of the government to plan, implement and evaluate nutrition related activities. Given the high incidence and prevalence of tuberculosis (TB) in Afghanistan, USAID also supports detection, treatment, and control efforts.
BUILDING CAPACITY IN THE HEALTH SYSTEM
USAID has provided capacity-building support to the MoPH to enhance its financial, procurement, and management systems. 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 DEMAND FOR AND ACCESS TO HEALTHCARE
USAID helps make affordable health products more widely available to rural, low-income populations by expanding private-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.
- Initiative for Hygiene, Sanitation and Nutrition (IHSAN)
- Health Sector Resiliency (HSR)
- Enhancing Community Access & Utilization of Zinc and ORS for the Management of Childhood Diarrhea in Afghanistan
- Afghanistan Demographic Health Survey (ADHS)
- Challenge TB
- Delegated Cooperation for Nutrition
- Disease Surveillance and Prevention
- HEMAYAT: Helping Mothers and Children Thrive
- Leadership, Management, Governance (LMG)
- Strengthening Pharmaceutical Systems
- Weekly Iron Folate Supplement Program
- 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 Care Improvement (HCI) Project
- Health Policy Project (HPP)
- Health Services Delivery Grant - Performance-based Partnership Grants (PPG)
- 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
- Partnership Contracts for Health (PCH)
- Routine Immunization in Afghanistan
- Rural Expansion of Afghanistan's Community-based Healthcare (REACH)
- Strengthening Immunization in Afghanistan
- 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 26, 2016