Our goal is to reduce the morbidity and mortality of the Afghan population by implementing a package of health and hospital services, special programs, and human resource development. 

Five-Year Strategic Benchmarks

The stated goal of the health sector will be realized through four inter-related and mutually supporting programs.

Program 1: Extending the Basic Package of Health Services

By end-2010, in line with Afghanistan’s MDGs, the Basic Package of Health Services will be extended to cover at least 90% of the population, maternal mortality will be reduced by 15%, and full immunization coverage for infants under-5 for vaccine preventable diseases will be achieved and their mortality rates reduced by 20%. 

In line with Afghanistan’s MDGs, the Basic Package of Health Services will be extended to cover at least 90% of the population, maternal mortality will be reduced by 10%, and full immunization coverage for infants under-5 for vaccine preventable diseases will be achieved and their mortality rates reduced by 20%.  BPHS has two objectives: to provide a standardized package of basic services which form the core of service delivery in all primary health care facilities; and to promote a redistribution of health services by providing equitable access, especially in underserved areas.  The defined package is being offered as four standard types, ranging from outreach by community health workers, to outpatient care at basic health centers, to inpatient services at comprehensive health centers and district hospitals.  The package has a strong focus on conditions that affect women and children.  It entails basic services at low cost, addressing the main causes of morbidity and mortality and aiming to provide health services to all Afghans, especially those who are poor and live in remote and rural areas.

Program 2: Extending the Essential Package of Hospital Services

1. By end-2010, the EPHS will be implemented in 50% of provincial and regional hospitals.

2. By end-2010, community boards will be established in 50% of all provincial and regional hospitals.

3. By end-2010, the proportion of district and provincial hospitals providing good quality emergency obstetric care will be increased to 80%.

Hospitals in Afghanistan play an important role in the health sector since they are part of the referral system that aims to reduce the high maternal and early childhood mortality rates.  The overall goal of the ‘Essential Package of Hospital Services’ (EPHS) is to improve the quality of care at secondary and tertiary health care level.  Main strategies to implement the EPHS are developing standards for hospital management, clinical care, and supportive services; building the hospital and clinical case management capacities of hospital staff; completing the Priority Restructuring and Reform process at secondary and tertiary health care level; providing hospitals with required medical supplies and equipment in a timely and regular fashion.

Program 3: National Communicable and Non-Communicable Disease Control Program

1. By end-2010, a low prevalence of HIV positive cases (<0.5%) in the population will be maintained in order to reduce mortality and morbidity associated with HIV/AIDS.

2. By end-2010, malaria morbidity will be reduced by 50% and malaria mortality will be reduced by 80%.

3. By end-2010, the risk of infection, morbidity, and mortality due to tuberculosis will be reduced by increasing Direct Observed Treatment-Short Course (DOTS) population coverage to 100% by end-2006.

4. By end-2010, at least 70% of infectious TB cases will be detected and at least 85% of those cases will be cured.

This program entails those that are not part of the ‘package’ programs, but follow a vertical approach for disease control up to a certain level (e.g. the provincial).  At the lowest level of delivery these programs are integrated, though due to special logistical and input requirements they have to be managed outside the BPHS and EPHS structure.  They are designed to have significant impact on the health of the population and include, beside the principal programs, control of tuberculosis, malaria and HIV/AIDS, eye care, the control of leprosy, and leishmaniasis.

Program 4: Health Sector Human Resource Management

By end-2010, suitably qualified, appropriately skilled, balanced, and motivated staff for the health sector will be equitably deployed throughout Afghanistan to deliver the BPHS and EPHS.

The attainment of the overall goal of the health sector is dependent upon the appropriate selection, appointment, and management of appropriately trained health professionals.  The current evidence on the status of health workers indicates that there are major challenges to ensuring the availability of suitably qualified, appropriately skilled, balanced, and motivated health workers throughout Afghanistan.  In order to achieve the main strategies of the program, MoPH has partnered with the Civil Service Commission to implement the transparent, competitive recruitment process to affect PAR.  Work will be undertaken with donors and technical partners to upgrade capacity of the recruited workforce and to encourage more female school leavers to enter the health profession, particularly nursing and midwifery in upgraded health training institutions.  Continuing education and retesting will increasingly be required for health workers.

Also fundamental to improved health care will be food security programs aimed at reducing the extremely high rate of infant and maternal malnutrition.  This strategy recognizes the multiplicity of factors that contribute to good nutrition in rural communities and gives priority to increasing food diversity and opportunities for the improvement of real incomes.  Nutritional education proposes ways to improve access to markets, measures to reduce pre- and post-harvest crop losses, measures to improve food safety, and the development of an early-warning capacity.