Building on Early Gains in Afghanistan's Health, Nutrition, and Population Sector: Challenges and Options (Directions in Development)

Afghanistan has made considerable progress since 2001. A nationwide survey conducted in late 2006 found that the IMR had fallen to 129 per 1,000 live births, and the U5MR had fallen to191 per 1,000 live births, representing a 22 percent and 26 percent decline, respectively, from the end of 2001. Similarly, prenatal care coverage has increased from less than 5 percent to 32 percent, and DTP3 coverage has increased from less than 20 percent to 35 percent between 2003 and 2006. Administrative data indicate that the number of functioning primary health care facilities has nearly doubled from 498 in 2001 to more than 936 in 2008. The quality of care in publicly financed facilities also has increased by about 22 percent from 2004 to 2006. Despite this progress, much still remains to be done. Although progress in the health sector is encouraging, it is not sufficient to ensure that Afghanistan will achieve the Millennium Development Goals (MDGs). The challenges include revising the content of the BPHS, rethinking the delivery of the BPHS, securing sustained and predictable financing, the emerging private sector, shortage of human resources for health, and the building the capacity of the ministry to enable it effectively carry out its stewardship functions. The volume presents specific policy options for the MOPH to consider to further build on the early gains made in the health sector. The guiding principles of these options are consistency with the Ministry’s vision and feasibility on implementation. These policy options tell a story with the central theme of expanding service coverage and what the Ministry needs to do to make that happen. Annotation This volume is the first of its kind to present a comprehensive assessment of the health sector in Afghanistan. Although health outcomes here are some of the worst in the world, the sector has made considerable progress since 2001. A nationwide survey conducted in late 2006 found that the infant mortality rate had fallen from 165 to 129 per 1,000 live births, and the under-five mortality rate had fallen from 257 to 191 per 1,000 live births. These figures represent a 22 percent and a 26 percent decline, respectively, from the end of 2001. Similarly, coverage of prenatal care has increased from less than 5 percent to 32 percent, and childhood vaccinations of DPT3 (diphtheria, pertussis, and tetanus) have increased from less than 20 percent to 35 percent between 2003 and 2006. Administrative data indicate that the number of functioning primary health care facilities has nearly doubled, from 498 in 2001 to more than 936 in 2008. Also, the quality of care in publicly financed facilities has increased by about 22 percent from 2004 to 2006. Although this progress is encouraging, it is not sufficient to ensure that Afghanistan will achieve the Millennium Development Goals (MDGs).'Building on Early Gains in Afghanistan€™s Health, Nutrition, and Population Sector' presents specific policy options for Afghanistan€™s Ministry of Public Health to consider in advancing to the next level of care for its population. The guiding principles of these options are consistency with the ministry€™s vision and the feasibility of implementation. The specific challenges include revising the content of the basic package of health services (BPHS), rethinking the delivery of the BPHS, securing sustained and predictable financing, defining the role of the emerging private sector, addressing the shortage of human resources for health, and expanding the capacity of the ministry to enable it to effectively carry out its stewardship functions.This book was prepared as a resource for policy makers, practitioners, and researchers in Afghanistan and other conflict-affected countries. It emphasizes the policy implications of the findings presented This volume is the first of its kind to present a comprehensive assessment of the health sector in Afghanistan. Although health outcomes here are some of the worst in the world, the sector has made considerable progress since 2001. A nationwide survey conducted in late 2006 found that the infant mortality rate had fallen from 165 to 129 per 1,000 live births, and the under-five mortality rate had fallen from 257 to 191 per 1,000 live births. These figures represent a 22 percent and a 26 percent decline, respectively, from the end of 2001. Similarly, coverage of prenatal care has increased from less than 5 percent to 32 percent, and childhood vaccinations of DPT3 (diphtheria, pertussis, and tetanus) have increased from less than 20 percent to 35 percent between 2003 and 2006. Administrative data indicate that the number of functioning primary health care facilities has nearly doubled, from 498 in 2001 to more than 936 in 2008. Also, the quality of care in publicly financed facilities has increased by about 22 percent from 2004 to 2006. Although this progress is encouraging, it is not sufficient to ensure that Afghanistan will achieve the Millennium Development Goals (MDGs). 'Building on Early Gains in Afghanistan’s Health, Nutrition, and Population Sector' presents specific policy options for Afghanistan’s Ministry of Public Health to consider in advancing to the next level of care for its population. The guiding principles of these options are consistency with the ministry’s vision and the feasibility of implementation. The specific challenges include revising the content of the basic package of health services (BPHS), rethinking the delivery of the BPHS, securing sustained and predictable financing, defining the role of the emerging private sector, addressing the shortage of human resources for health, and expanding the capacity of the ministry to enable it to effectively carry out its stewardship functions. This book was prepared as a resource for policy makers, practitioners, and researchers in Afghanistan and other conflict-affected countries. It emphasizes the policy implications of the findings presented.

A number of development partners, including the World Bank, have been actively supporting the health sector in Afghanistan since 2003-04 (1382 AC). Collectively, they invested more than $820 million between 2003 (1382 AC) and 2008-09 (1387 AC) and played key roles in supporting the government in reshaping the country's health sector. This support continues, with all partners starting new projects aimed at further strengthening the sector and building on the successes that have been achieved. The book is organized as follows. Chapters one-four tell a coherent story about the achievements of the sector between 2002 and 2008 (1381-87AC), the financial resources used to achieve the results, and the contribution the private sector has made to the achievements. Chapters five-eight) look forward. They identify the challenges the sector is facing in meeting human resource needs, expanding the coverage of the basic package of health services (BPHS), and increasing the institutional capacity of the Ministry of Public Health (MoPH). Chapter eight summarizes the lessons learned and provides options for moving forward.

Presents specific policy options for the MOPH to consider to further build on the early gains made in the health sector in Afghanistan. The guiding principles of these options are consistency with the Ministry’s vision and feasibility of implementation. These policy options tell a story with the central theme of expanding service coverage and what the Ministry needs to do to make that happen. Tekabe A. Belay, Editor. Includes Bibliographical References (p. 185-187) And Index.