Health system
Afghanistan’s health system has been steadily progressing over the last 17 years, with increasing coverage of health services throughout the country. In 2018, a total of 3,135 health facilities were functional, which ensured access to almost 87% of the population within two hours distance. Afghanistan’s National Health Policy 2015-20 has five policy areas: governance, institutional development, public health, health services and human resources. The recently developed One UN strategy focuses on Health System Strengthening among other health topics. WHO and UN agencies are helping the government to implement the National Health Policy 2015-20 and Strategy 2016-2020.
Achievements
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§ As co-chair of the Development Partners Forum, WHO provided technical support to MoPH and partners to strengthen policy dialogue, coordination and harmonization of programmes in the sector, and the mobilization of resources.
§ Supported the development of a new health package for UHC.
§ Assisted in the formulation of a National Health Strategy 2016-20.
§ Helped the development of SEHATMANDI (2018-21).
§ Supported the establishment of a Health Sector Strategic Oversight Committee, chaired by H.E Minister.
§ Supported the development of a fourth round of National Health Accounts.
§ Established and strengthened the first Afghan Medical Council.
§ Strengthened the National Medicines and Health Regulatory Authority.
§ Implemented the patient safety programme in 17 hospitals.
§ Updated the National Medicine Policy and National Formulary of Medicine.
§ Formulated the National CRVS strategy and facilitated development of tools for the implementation of ICD10 at hospital level.
§ Established mobile health teams (MHTs) in 12 provinces to provide nomadic populations with better access to basic health services.
§ Established the Public Private Partnership (PPP) model to provide basic reproductive health and immunization services in remote and insecure districts of six insecure provinces.
Health facility type
Number
Sub-centre
986
Basic Health Centre
873
Comprehensive Health Centre
432
District hospital
84
Provincial hospital
27
Regional hospital
9
Special hospital
30
Mobile clinic
242
Other
452
Total health facilities
3,135
Health posts
17,297
§ Supported the establishment of a public-private partnership for upgrading 142 private health facilities in insecure areas. The health facilities provide basic maternal and child health services, including immunization.
§ Established a call centre to support individual concerns on health issues.
Programme risks and challenges
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§ Sub-optimal utilization of services due to poverty and distance to health facilities.
§ Inadequate access to priority health services due to distance, high cost, low awareness, insecurity and shortage of female health care providers.
§ Reduced donor support for the health sector beyond June 2018.
§ Inadequate domestic resource allocation to health.
§ Low level of execution capacity particularly at the sub-national level.
Way forward
WHO with MoPH and key partners have identified health system development as one of their key priorities, including support to: implementation of the National Health Policy and Strategy, revision of BPHS/EPHS and development of minimum package of health services for Universal Health Coverage, government leadership and regulatory role and integrated health service delivery in line with Sustainable Development Goals (SDGs) and Afghanistan National Peace and Development Framework.
