Transforming Development Beyond Transition in Afghanistan: Service delivery
This paper is one of a series highlighting civil society actors’ concerns in the lead up to the 2014 London Conference on the Tokyo Mutual Accountability Framework (TMAF). Other papers in the series focus on aid effectiveness, governance and women’s rights.
The lack of reliable, extensive and comparable data is an issue affecting developing countries, in particular Afghanistan and its most isolated and conflict-impacted areas. This heavily affects the analysis of the service delivery sector and complicates proper and systematic analysis on progress, the remaining gaps and needs. However ACBAR members have used their extensive knowledge of Afghanistan and long-term field experience to develop the following analysis and recommendations.
Progress since 2012:
In the past decade, significant progress has been made in Afghanistan in terms of delivering services to the population, in particular health and education. According to the Ministry of Public Health (MoPH), 9 per cent of the population was living in districts where health facilities were accessible in 2001, compared to 86.7 per cent in 2011.1 Knowledge and acceptance of health practices by communities has also improved greatly. Basic understanding of hygiene practices, the need for vaccinations, specific care for mothers and newborn infants, and reproductive healthcare is more widespread.
This can be partially attributed to community-based approaches to health combined with better communication and awareness projects, as well as increased recruitment and training of female health workers as a result, various health indicators have improved.
The maternal mortality rate reduced dramatically from 1,000 deaths per 100,000 live births in 20002 to 327 in 2013.3 Under-five mortality rates reduced from 131 deaths in every 1,000 live births in 2001, to 91 in 2011–12.4 Life expectancy went from 44.5 years at birth in 20015 to 62–64 years in 2010. 6 These improvements are also the result of a proactive national public health policy, implemented by the MoPH, which in most of the provinces contracts out the implementation of its Basic Package of Health Services and its Essential Package of Hospital Services (BPHS/EPHS) to competent non-government organizations (NGOs) who deliver the services to communities.
The paper also highlights challenges, mostly on the following topics.
· Problems of access:
· Poor quality of services:
· Awareness and inclusion ACBAR recommends to principal actors:
- The international community should commit sufficient long-term funding for the development of the country, in particular in areas of health, education and rural development to ensure that progress is sustained and enhanced in the future, with programming focused on the existence of humanitarian needs and support independent funding mechanisms and practical delivery of humanitarian aid to meet these needs, in particular for populations living in conflict zones.
Both the Afghan government and the international community should ensure that education and health facilities and staff are respected, in particular by armed forces and political actors. The neutrality of these services needs to be protected as per international humanitarian and human rights laws. answering the current gaps, and improving overall quality of services based only on the needs of the local population, and not on military and political agendas.
The Afghan government should focus on the overall quality of services by improving service delivery systems and policy implementation in the field. It should also: increase number of services available in the under-served areas to ensure adequate availability as per guidelines and international recommendations; update and harmonize policies to tackle on-the-ground difficulties; ensure allocation of appropriate levels of funding for programme implementation, targeting quality of services and availability of supplies
Both the Afghan government and the international community should focus on improving service delivery to the most contested and violent areas, where populations are disproportionately suffering from inadequate service provision. Acknowledge the existence of humanitarian needs and support independent funding mechanisms and practical delivery of humanitarian aid to meet these needs, in particular for populations living in conflict zones.
Both the Afghan government and the international community should ensure that education and health facilities and staff are respected, in particular by armed forces and political actors. The neutrality of these services needs to be protected as per international humanitarian and human rights laws.
You are cordially invited to attend the half-day workshop “Urban Displaced Youth in Kabul” on Tuesday October 28, 2014 at the Queen’s Palace, Babur Garden.
This study was funded by Samuel Hall with the support of a technical working group composed of ACBAR, UNHCR, IOM, ILO, UNFPA, and UNHABITAT.
The workshop agenda is attached: three key themes Mental Health, Skills and Social Inclusion for Displaced Youth in Kabul will be highlighted through a presentation of the main findings of the study and participants’ input to the recommendations through working groups. The report will be finalized after the workshop and launched in November 2014.
This research is the first comprehensive survey of Urban Displaced Youth (15-24 years) in Kabul conducted with a representative sample of 2,000 youth in the Fall 2013, including returning refugees, returning migrants (voluntary and forced), IDPs, rural-urban migrants and non-migrants. This study responds to the need for more youth-sensitive policies, by providing the evidence base on the profiles and needs of displaced youth in Kabul.
The workshop is organized by ACBAR and funded by Tawanmandi.
To attend this event, RSVP before October 25th, 2014 at email@example.com and firstname.lastname@example.org - See more at: http://www.acbar.org/news/91/ACBAR-Newsletter--October-2014.html#sthash.3RLtH5QF.dpuf