Attachments
Health Approach
The 2024 HNRP estimates that 17.9 million people in Afghanistan require health assistance in the same year, within a context characterised by a fragile and under-resourced healthcare system, fraught by unequal access to services, ongoing communicable disease breaks, critical unmet maternal and child health needs, high rates of malnutrition, and significant morbidity and mortality rates as result. Acute disease outbreaks continue to challenge Afghanistan’s health sector, including measles, acute watery diarrhea (AWD), dengue fever, pertussis, Crimean Congo Hemorrhagic Fever (CCHF), and malaria.
UNICEF has reported Afghanistan having one of the world’s highest maternal mortality rates with 638 mothers dying for every 100,000 births, exacerbated by acute shortages of qualified birth attendants in the country. Health outcomes are further hampered by an under-resourced healthcare system and poor infrastructure, disproportionately affecting rural and under-served communities.
Despite efforts to improve the country’s healthcare infrastructure, Afghanistan continues to grapple with systemic issues that hinder effective healthcare delivery. Analysis of under-served areas shows that 13.2 million people in 34 provinces reside in areas where primary healthcare services are not accessible within a one-hour walking distance.
UNHCR’s approach to health is aligned with the United Nations Strategic Framework for Afghanistan, and is based on a multifaceted approach aimed to address core gaps in services linked to critical protection gaps, resulting in barriers to durable solutions. Health programs delivered by UNHCR centres on sustainable outcomes and improving access to quality healthcare services for returnees, IDPs, and vulnerable host communities.
Interventions are based on consultations with key local stakeholders to accurately identify and address gaps in essential services, and integrate gender considerations and variances in needs and protection risks faced by women, men, girls, boys, and other diversity groups from the outset. Health interventions are further delivered through UNHCR’s Priority Areas for Return and Reintegration (PARRs) area-based approach, ensuring that activities lead to sustained essential healthcare services benefitting IDPs, returnees, and host communities, contributing to strengthened community resilience, self-reliance and social cohesion. Under this framework, UNHCR delivers essential health infrastructure, including equipping facilities, training of new staff, and close coordination with key health stakeholders for complimentary programming and operationalization of facilities for sustainable outcomes.
Scope of interventions
Construction of health facilities with protection dividends to addresses critical gaps in access to quality healthcare infrastructure in line with specific needs and priorities of target communities. Infrastructure projects are derived from robust consultation processes with communities and local stakeholders, combined with data gathering on needs on the ground to identify core service gaps. Construction processes are guided closely by UNHCR country-level Standard Operating Procedures (SOPs), feasibility assessments, and technical surveys, ensuring standardized, accountable, and quality assured processes and outcomes.
Midwifery training initiatives* address critical gaps in qualified birth attendants across the country and ensure that female patients have access to gender-sensitive care. The midwifery training initiative is a structured 3-year program that provides theoretical and practical education for women, facilitating access to employment and encouraging local investments in the success of health facilities through active participation of community members. UNHCR’s programs work to integrate these midwives into health facilities, ensuring sustainable healthcare provision and strengthening of the healthcare workforce in Afghanistan.
Delivery of regular health outreach sessions within communities, raising awareness on the importance of accessing maternal healthcare for prenatal, delivery, and postnatal care. This initiative enhances understanding and awareness, ensuring that communities are well-informed and engaged, and facilitates supportive environments that encourage the use of maternal health services, contributing to successful and impactful health service delivery.
*The future of midwifery training programs is pending further information following the reported new DfA directive to block women and girls from attending private medical institutions. UNHCR aligns with UNAMA’s statement on the new reported directive.