Afghanistan: 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 (MoPH), USAID provides health services by working through community-based volunteer health workers at all levels in the health care system—from basic health centers at the village level to provincial hospitals. Over 7 million people in 14 provinces now have better access to quality health services. Approximately 70% of patients served are women and children. USAID has:

• Supported 331 active health service sites by December 2005, serving an average of 989 patients every month.
• Supplied $1.8 million worth of essential drugs since 2003.
• Provided treatment and counseling to approximately 340,000 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 5,894 midwives and community health workers who now provide basic health services in their communities.
• Graduated 337 midwives from USAID-funded training courses since 2003. 493 are currently enrolled in training.
• Trained over 1,143 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 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 among 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 sold more than 6,886,356 health products through the private sector.

Clinic Construction
In conjunction with the MoPH, USAID is building and renovating clinics throughout the Afghan countryside to provide easier access for greater numbers of patients primarily throughout the remote rural areas which were previously without health service coverage.

• By December 2005, USAID in collaboration with the MOPH and contractors have completed some 454 health clinics and handed them over to the Government of Afghanistan and local health agencies.
  

• ARZU, Inc.
• The Asia Foundation
• CHF International
• Christian Children’s Fund
• Creative Associates International, Inc.
• Education Development Center
• International Organization for Migration
• Management Sciences for Health
• Population Services International
• Shelter for Life International
• United Methodist Committee on Relief
• United Nations Children’s Fund
• United Nations Development Program
• United Nations Office for Project Services
• University of Nebraska

More Information

• Success Story: Meeting the Needs of the Disabled (pdf - 161k)
• Success Story: Eliminating Polio (pdf - 157k)

HEALTH SNAPSHOT

Improved access to quality health services for 7.4 million people in 14 provinces.

Supplied $1.8 million worth of essential drugs since 2003.

Trained 5,894 midwives and community health care workers who now provide basic health services in their communities.

Health Profile
(pdf - 155k)

CONTACTS
Mission Director
Alonzo Fulgham
USAID/Kabul
6180 Kabul Place
Dulles, VA 20189-6180
Tel: 873-762-311955

Desk Officer
Sepideh Keyvanshad
Tel: (202) 712-0324
Email: skeyvanshad@usaid.gov
www.usaid.gov/afghanistan