Expanding Community-based Healthcare

Overview

USAID’s health program focuses on increasing access of women and children to quality basic health services, especially in rural and underserved areas. Much of the service delivery and training is provided through grants to local and international NGOs. The value of grants awarded to date is $50 million.

Delivery of Quality Health Services
In collaboration with the Ministry of Public Health, USAID provides direct access to health services for 7.1 million people living in 14 provinces. Through this support to health facilities at all levels in the health care system—Basic Health Centers to Provincial Hospitals, supplemented by community-based volunteer health workers—people of these provinces are experiencing better access to quality health services. To date, USAID has:

• Supported 294 active health facilities by June 2005; this number is projected to expand to 323 by the 2006 project end.
• Supplied $1.8 million worth of essential drugs since 2003.
• Provided treatment and counseling to approximately 322,000 patients monthly.

Health Training and Education
This program focuses on health providers, women and the community by training volunteer community health workers and midwives. Practicing doctors, nurses, and midwives receive refresher training with USAID support. USAID also provides health-oriented accelerated literacy training to prepare girls and young women to enter into the health professions. Health education materials are also developed for the general public. USAID has:

• Trained 3,200 community health workers who now provide basic health services in their communities; an additional 2,700 are currently in training.
• Graduated 187 midwives from USAID-funded training courses since 2003.
• Trained over 700 doctors, nurses and midwives in one or more refresher training modules since 2003.

Building Capacity in the Health System
USAID works with the MoPH to develop and advance policies and guidelines in diverse health areas such as basic health services, pharmaceutical standards, and emergency obstetrics care. In addition, USAID helps the MoPH to develop and maintain essential public health management systems. Activities include participation in over 20 MoPH working groups and task forces to develop over 60 policies, standards and guidelines

Social Marketing
More than 60% of households in Afghanistan drink unsafe water and, as a result, diarrheal disease is the leading cause of death amongst children under five. To address this, USAID launched Clorin in June 2003, a safe water system to treat water at point of use. USAID is also increasing underserved populations access to safe water, reproductive health choices, and malaria prevention.

By leveraging the existing private sector infrastructure and a market-based approach, USAID is making information, products and services available to low-income and other vulnerable people. For malaria prevention, USAID launched Safenite (long-lasting insecticide treated bednets) in September 2004. The bednets are distributed through household goods shops, hardware stores, bedding stores and wholesale pharmaceutical outlets. Specifically, USAID has:

• Trained 450 community leaders and health professionals in malaria prevention, 1,971 in reproductive health and 1,789 in hygiene education.
• Distributed 79,786 bednets and 40,500 bednet retreatment tablets for malaria prevention through May 2005.
• Delivered 377,527 bottles of Clorin water disinfectant through May 2005.

Clinic Construction
Women and children should not have to forego medical treatments due to a lack of facilities. In conjunction with the MoPH, USAID is building clinics throughout the Afghan countryside to provide easier access for greater numbers of patients.

• Constructed 287 health clinics since 2002. An additional 43 clinics are currently under contract.

ARZU, Inc.

The Asia Foundation
http://www.asiafoundation.org/Locations/afghanistan.html

CHF International
http://www.chfhq.org/section/worldwide_programs/programs/asia/afghanistan

Christian Children’s Fund
http://www.christianchildrensfund.org/content.aspxid=187

Creative Associates International, Inc.
http://www.caii.net

Education Development Center
http://main.edc.org/search/projectView.aspbcn=0&bcl=Return%20to%20Asia&ProjectID=3485

International Organization for Migration
http://www.iom.int

Management Sciences for Health
http://www.msh.org/afghanistan

Population Services International
http://www.psi.org/where_we_work/afghanistan.html

Shelter for Life International
http://www.shelter.org/Website_2004/afghanistan.html

United Methodist Committee on Relief
http://gbgm-umc.org/umcor

United Nations Children’s Fund
http://www.unicef.org/infobycountry/afghanistan_afghanistan_latest.html

United Nations Development Program
http://www.undp.org.af

United Nations Office for Project Services
http://www.unops.org

University of Nebraska

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