Afghanistan: Health Cluster Strategic Response Plan 2017
4.6 million people in need
3.8 million to receive assistance
$53 million required
Afghanistan is one of the longest protracted emergencies with an increasing drift of conflict and remaining exposed to frequent natural disasters and resulted mass population movement. The conflicts have direct impact on the health status of affected populations physically and mentally as they affect the function and capacity of health care service as well as the humanitarian access. Between January and September 2016, 57,000 weapon induced wounded have been reported through FATPs and specialized trauma care centers, which shows close to 20% increase in war trauma incidence in comparison to 2015. Similarly, displacement of population due to conflict and natural disasters, inadequate shelter, insufficient and unsafe water, and inadequate sanitation poses significant risk factors associated with potentially life threatening infectious disease outbreaks.
The extensive population movements in the country exacerbate the circumstances with significant numbers of IDPs, returnees and refugees congregating in urban centres and the outskirts where basic service provision and infrastructure is unable to absorb the additional burden, and services are overwhelmed or simply not available to address mounting needs. The situation is further compounded with the return of 600,000 returnees during 2016 as over 1 million more expected to return by summer 2017. The mass return of refugees also raises concerns related to disease outbreaks due to the influx of population with inadequate or no immunity against polio and other vaccine preventable diseases.
The conflict continued to cause damage, disruption to social services and negatively affect the health situation and health care services as the upsurge of conflict has expanded to the North and North East regions causing more displacement. The resulting war trauma, physical injuries and mass displacement have increased people’s need for health services and medical care far surpassing the capacity and resources of the basic services available through the country’s health system.
The recurrent episodes of emergencies have tremendously strained the capacity of health services delivery reflected with a high infant (73/1000 live births) and maternal mortality rates (327/100,000 live births), low immunisation coverage (less than 75% coverage for Measles in one quarter of districts), and compromised access to quality health and nutrition care. Only 32.9% of deliveries take place in health facilities and 27.7% of post-natal care is provided by trained health staff with around 920,000 women at reproductive age (15-49 years) in need of reproductive health services including emergency obstetric care in the most affected areas. There is sub-optimal immunization coverage in one quarter of the districts which results in widespread outbreaks of measles and pertussis among <5 years old children as almost all the major outbreaks are reported from the conflict affected locations.
While the vulnerable pockets of populations are exposed to higher risk of trauma incidents and other health effects of conflicts and natural disasters, the limitation in availability of essential health care services in the white and conflict affected areas is compounding the situation resulting in higher morbidity and mortality among the most vulnerable population of the country.
Access to essential health services is an immediate need for over five million people leaving roughly 36% of the Afghan population with no access to essential primary health care services such as OPD, ANC, deliveries, PNC, neonatal and child care, including vaccination. A total of 403 outbreaks were reported with 171 laboratory confirmed outbreaks between 1st January to 31st December 2016, compared to 450 reported and 218 laboratory confirmed outbreaks reported during the same period of 2015.
Further, delivery and availability of life saving medicines and medical equipment is interrupted due to insecurity, road inaccessibility and disruption of basic services including electricity and cold chain system. The interruption of medical supply chain also causes stock-outs of life-saving medicines in all levels of health care delivery system including referral hospitals.