IMCI course T -28SEPTEMBER-W ith45womendyingperday frompreventablecausesis evidencethatwomen’s...
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Major achievements 2003 Priorities for 2004 ? ? ? ? ? ? ? ? ? ? ? ? ? MoH adopted onApril7,2003,theIMCI strategy Establishment of an IMCI management structureandworking Group nomination of a national IMCI coordinatorandafocalpoint Creation of the Adaptation, implementation, family and communitysubgroups Adaptationofthetrainingmaterials and selection of the early implementationanddevelopmentof aNationalPlan Fellowshipstosixnationalstoattend an IMCI caseManagementtraining in Sudan to gain experience and accelerate the process of implementation Trainingof34Nationalsintheearly implementationareas Implementation of the IMCI three components in Kabul Wardak, and NangarharProvinces. Establishtheappropriatemanagerial IMCI structureatprovinciallevelin theselectedprovincesforexpansion Promote theaccurate identification of childhoodillnesses inoutpatient settings Ensure appropriate combined treatmentofallmajorillnesses, Ensurethenecessaryhealthfacility support with the relevant supplies andequipments Strengthen the counseling of caretakers Speedupthereferralofseverelyill children Promote appropriate care seeking behaviors, improved nutrition and preventative care, and the correct implementationofprescribedcarein thehomesetting Reviewandexpandtheexperience tootherprovinces. through a Ministerial Degree, ? Facilitators training course - 28SEPTEMBER- 2 OCTOBER2003 ND Creating a pool of National Facilitatorisanessentialstepin theIMCIapproach.Priortothe first National IMCI 11-days training course the Ministry of HealthandWHOorganizedthe first training offacilitators from 28 September-2 October 2003, at the Indira Gandhi InstituteofChildHealth. nd The 9 participants included senior pediatricians and medical officers from Kabul Medical Institute, MoH, Indira Gandhi Hospital, Atatork Children Hospital, Mywand Paediatric Hospital and 3 Medical Officers (2 from Safe Children US and one freelance). All candidateshadparticipated in an IMCI training course in SudanandPakistansponsored byWHO. Outpatient clinical sessions were organized in Q-i- Zamankhan Health Centerand QabelMCHclinic. Using the guide for outpatient clinical sessions, participants were introduced to various facilitation techniques, assigned patients, conducted clinical demonstrations, practicedfillingrecordingforms andmonitoredperformance. Both sick, young infants and children from 2 months to 5 years of age were consulted and their conditions demonstrated. T he Afghan Ministry of health adhered to the Integrated Management of Chilhood Illnesses (IMCI) approach through a ministerial degreeasoneofthemajorpoliciesto reduceinfantandchildmortality.The ministerial decree,taken onApril 7, 2003, established the IMCI Management structureattheCentral level. Training methods used included videos, photograph booklets, role plays, individual andgroupfeedback, drills, discussions and hands-on clinicalpractice. Senior officials from MOH, decision makers,NGOsandotherpartnerswere were first introduced to the Global development of the IMCI approach during a joint WHO/MOH/UNICEF orientation workshop. Participants learned from experiences in 120 countries where the IMCIstrategy is alreadyoperationalandsuccessfully implemented. Early April 2003,the three IMCI working groups collected informationtopreparefortheIMCI earlyimplementationphase. These groups produced theAdapted Afghanistan version of training materials, mother card and feeding recommendations. The group set criteria for the selection of provinces/districts, assessed health facilities and infrastructure. Plansofactionpreparedbyallgroups oftheIMCIwerereviewed,compiled andendorsedbyMoHastheNational Plan for the early implementation phase,inAugust2003,ataNational PlanningWorkshop Generic materials adapted to the Afghan context were approved and endorsed by MoH at a consensus workshopconducted,inAugust2003 priortotheplanningworkshop. Exposureof6nationals totheIMCI experience inSudanacceleratedthe process of adaptation and implementation. Diseases such as pneumonia, diarrhoea, malaria, measles, and malnutrition all prevalent in Afghanistan are major causes of mortality and morbidity in children under five years of age in the developingworld. Cost-effectiveapproachessuchasthe IntegratedManagementofchildhood diseases, as developed by UNICEF and WHO, has proved its cost- effectiveness in the reduction of morbidity and mortality among childrenofthisagegroup. A full implementation of the IMCI improves the identification of illnesses in health care settings, ensures appropriate treatment of majorillnesses,andrationalizesthe referralofseverelysickchildren.The IMCI incorporates disease prevention through promotion of breast feeding, counselling on nutrition and immunization of sick children. The major components of IMCI are improvements in (1) the skills of health staff in case management of common childhood illness (2) the health system needed to allow effective management of childhood illnesses and (3) family and community practices. First nationalIMCICase management course IMCI Orientation Workshop- 30 January 2003 Development of human resources to ensure a qualitative implementation o f the IMCI was selected as a decisive component of the strategy in Afghanistan. End of October WHO financially and technically supported an 11- day case management skills training course for firstlevelhealthfacilitiesworkers. The course conducted by a clinical instructoraidedby three facilitators from Sudan, wasdesigned for theMinistry of Health officials, program coordinators, academicians, NGOs, other partners and members of theIMCI working groups t o furtherexposethemtotheIMCIapproach. Assess and classify children under 5 years presenting fever, diarrhoea, ARI, MeaslesandMalnutrition Identify seriousclassificationsrequiring referral Identifyandtreatclassificationsthatneed treatmentathealthfacilityorathome Counselmotherson homemanagement and theirownhealth Reassessthechildonfollow-upvisitsand provideappropriatecare The course pursued the followingobjectives: ? ? ? ? ? National IMCI planning workshop… &ConsensusWorkshop IMCI
Transcript of IMCI course T -28SEPTEMBER-W ith45womendyingperday frompreventablecausesis evidencethatwomen’s...
Majorachievements2003
Priorities for 2004
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MoH adoptedonApril7,2003,theIMCI
strategy
Establ ishment of a n IMCImanagement structureandworkingGroup
nomination of a national IMCIcoordinatorandafocalpoint
Creation of the Adaptation,implementation, family andcommunitysubgroups
Adaptationofthetrainingmaterialsand select ion o f the ear ly
implementationanddevelopmentofaNationalPlan
Fellowshipstosixnationalstoattendan IMCI caseManagementtrainingin Sudan to gain experience anda c c e l e r a t e t h e p r o c e s s o fimplementation
Trainingof34Nationalsintheearlyimplementationareas
Implementation of the IMCI threecomponents in Kabul Wardak, andNangarharProvinces.
EstablishtheappropriatemanagerialIMCI structureatprovinciallevelintheselectedprovincesforexpansion
Promote theaccurate identification
of childhoodillnesses inoutpatientsettingsEnsure appropriate combinedtreatmentofallmajorillnesses,
Ensurethenecessaryhealthfacilitysupport with the relevant suppliesandequipments
Strengthen the counseling ofcaretakers
Speedupthereferralofseverelyillchildren
Promote appropriate care seekingbehaviors, improved nutrition andpreventative care, and the correctimplementationofprescribedcareinthehomesetting
Reviewandexpandtheexperiencetootherprovinces.
through a MinisterialDegree,
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Facilitators trainingcourse - 28SEPTEMBER-2 OCTOBER2003ND
Creating a pool of NationalFacilitatorisanessentialstepintheIMCIapproach.Priortothefirst National IMCI 11-daystraining course the Ministry ofHealthandWHOorganizedthefirst training offacilitators from28 September-2 October2003, at the Indira GandhiInstituteofChildHealth.
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The 9 participants includedsenior pediatr icians and
medical officers from KabulMedical Institute, MoH, IndiraGandhi Hospital, AtatorkChildren Hospital, MywandPaediatric Hospital and 3Medical Officers (2 from SafeC h i l d r e n U S a n d o n efreelance).All candidateshadparticipatedin an IMCI training course inSudanandPakistansponsoredbyWHO.
Outpatient clinical sessionswere organ ized in Q- i -Zamankhan Health CenterandQabelMCHclinic.
Using the guide for outpatientclinical sessions, participantswere introduced to variousf a c i l i t a t i o n t e c h n i q u e s ,assigned patients, conductedc l in i ca l demonst ra t ions ,practicedfillingrecordingformsandmonitoredperformance.
Both sick, young infants andchildren from 2 months to 5years of age were consulteda n d t h e i r c o n d i t i o n sdemonstrated.
The Afghan Ministry ofhealth adhered to theIntegrated Management ofChilhood Illnesses (IMCI)
approach through a ministerialdegreeasoneofthemajorpoliciestoreduceinfantandchildmortality.Theministerial decree,taken onApril 7,2003, established the IMCIManagement structureattheCentrallevel.
Training methods used includedvideos, photograph booklets, roleplays, individual andgroupfeedback,drills, discussions and hands-onclinicalpractice.
Senior officials from MOH, decisionmakers,NGOsandotherpartnerswerewere first introduced to the Globaldevelopment of the IMCI approachduring a joint WHO/MOH/UNICEForientation workshop. Participantslearned from experiences in 120countries where the IMCIstrategy is
alreadyoperationalandsuccessfullyimplemented.
Early April 2003,the three IMCIwork ing groups co l l ec t edinformationtopreparefortheIMCIearlyimplementationphase.
These groups produced theAdaptedAfghanistan version of trainingmaterials, mother card and feedingrecommendations.
The group set criteria for theselection of provinces/districts,assessed health facilities andinfrastructure.
PlansofactionpreparedbyallgroupsoftheIMCIwerereviewed,compiledandendorsedbyMoHastheNationalPlan for the early implementationphase,inAugust2003,ataNationalPlanningWorkshop
Generic materials adapted to theAfghan context were approved andendorsed by MoH at a consensusworkshopconducted,inAugust2003priortotheplanningworkshop.
Exposureof6nationals totheIMCIexperience inSudanacceleratedthep r o c e s s o f a d a p t a t i o n a n dimplementation.
Diseases such as pneumonia,diarrhoea, malaria, measles, andmalnutrition all prevalent inAfghanistan are major causes ofmortality and morbidity in childrenunder five years of age in thedevelopingworld.
Cost-effectiveapproachessuchastheIntegratedManagementofchildhooddiseases, as developed by UNICEFand WHO, has proved its cost-effectiveness in the reduction ofmorbidity and mortality amongchildrenofthisagegroup.
A full implementation of the IMCIimproves the identification ofillnesses in health care settings,ensures appropriate treatment ofmajorillnesses,andrationalizesthereferralofseverelysickchildren.TheI M C I i n c o r p o r a t e s d i s e a s eprevention through promotion ofbreast feeding, counselling onnutrition and immunization of sickchildren.
The major components of IMCI areimprovements in (1) the skills ofhealth staff in case management ofcommon childhood illness (2) thehealth system needed to alloweffective management of childhoodillnesses and (3) family andcommunity practices.
First nationalIMCICasemanagement course
I M C I O r i e n t a t i o nWorkshop- 30 January2003
Development of human resources toensure a qualitative implementation o fthe IMCI was selected as a decisivecomponent of the st ra tegy inAfghanistan.
End of October WHO financially andtechnically supported an 11- day casemanagement skills training course forfirstlevelhealthfacilitiesworkers.
The course conducted by a clinicalinstructoraidedby three facilitators fromSudan, wasdesigned for theMinistry ofHealth officials, program coordinators,academicians, NGOs, other partners andmembers of theIMCI working groups tofurtherexposethemtotheIMCIapproach.
Assess and classify children under 5years presenting fever, diarrhoea, ARI,MeaslesandMalnutritionIdentify seriousclassificationsrequiring
referralIdentifyandtreatclassificationsthatneed
treatmentathealthfacilityorathomeCounselmotherson homemanagement
and theirownhealthReassessthechildonfollow-upvisitsand
provideappropriatecare
The course pursued thefollowingobjectives:
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National IMCI planningworkshop…
&ConsensusWorkshop
IMCI
With45womendyingperdayfrom preventable causes isevidence that women’s
rights should be morecatered to inAfghanistan. This country possessesoneofthehighestmortalityratesintheworld (1600 per 100 000 live births)which translatesAfghanistan’slackofequitable, accessible and quantitativematernalandnewbornservices.
Morethan 90% of deliveries occur athome. Only 5% of deliveries areattendedbyskilledpersonnel.Referralsites and hospitals are located in ther e m o t e s t a r e a s w h e r e t h etransportation infrastructure isdestroyedbythedecadesofwar.
The five major causes of maternalmortality include hemorrhage, sepsis,obstructed labor, hypertensivedisorders of pregnancy and unsafeabortion. These are compounded byfamily and community practices thatimpede the well-being of pregnantwomenandtheirsiblings.
Reducing the maternal and neonatalmortality and morbidity rates is highontheAfghangovernment’sagenda.
In2003WHOprovidedtechnicalandpolicy support to MOH through theReproductive Health task forceincluding establishment of norms andstandards,adaptationofstandardtoolsformaternalandnewbornhealthcare.
Under the Belgium funded project, a
studywascarriedoutin2400villagesfromdifferentprovincestodetermine the role ofTBAs in improvingmaternal health inAfghanistan and toassist in addressingfuture s t ra tegiesaimed at phasing outof the services ofTBAs in favor ofskilledtrained healthpersonnel.
Maternal death reporting system havebeen established in Afghanistan’sEastern region hospitals to investigatethe causes of maternal deaths, helpidentifygapsinservices,andtoimprovethe quality of services and referralproceduresforobstetricalcomplications.
Establ ishment of aReproductive Health taskforce
Introduct ion of theMother-Baby Package
Reporting system forMaternalHealth
Maternal careprotocolsforAfghanistan
Strengthening maternaland child health careservicedelivery
Capacitybuilding
-atooltoguideactionsandinterventionsin the field of maternal and neonatalhealth.
In 2003 WHO trained female doctorsand midwives from five regions of
Afghanistan as Master Trainers ofTraditional Birth
The Mother-Baby Package wasintroduced in Afghanistan as animportant tool to guide actions andinterventions in the field of maternaland neonatal health. The Packagedescribes simple interventionsrequired before, during pregnancy,delivery, and after delivery for themotherandthenewborn.
The studywas carried out in2 4 0 0 v i l l a g e scovering all sevenr e g i o n s o fAfghanistan. Resultsare expected to bepublishedattheendof2003.
AMOH/WHOworkshopwasconductedinAprilthisyeartodesignmaternalcarep ro toco l s fo r A f g h a n i s t a n bystandardizing the content of maternalcare during antenatal and postpartumperiods.
Toimproveandstrengthenthematernaland child health care service delivery,WHOprovidedaround1800kgsofMCHsupplies and equipment (especially theessential obstetric care supplies andequipment) to 12 referral hospitals(provincialanddistrict)and40Maternaland Child Healthfacilitieswhich servearound120,000womenofchild-bearingageand180,000underfivechildren in2regionsofAfghanistan..
Formulate national policies andstrategies onintegratedreproductivehealthcareaspartofacomprehensivepackage in the national health caresystem;
Functioning quality birth-spacingservices;
Improved reproductive health care,withspecific focus onmaternal andneonatalservices;
I m p l e m e n t c o s t - e f f e c t i v einterventions aimed at promotingreproduct ive hea l th througho p e r a t i o n a l , c l i n i c a l a n depidemiologicalresearch;
Improve healthy reproductivepractices.
Develop and implement plans forstrengthening accessibility to andavailability of quality reproductivehealthcare;
Developmodellegislationforaright-basedapproachtoreproductivehealthforadoptionatthenationallevel.
Study on the role ofTBAs
attendants. Mastertrainers have trained 10 trainers each intheir respective regions who in turnwilltraintwohundredTBAsfromeachregion.The trained TBA trainers are alsoresponsibleforfollowup,supervisionandmonitoring of the TBAs. TBA kits andtrainingmaterialsareprovided to trainedTBAs andtoNGOstosupporttheirTBAtrainingprograms.
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Prioritiesfor2004
Maternal & Child HealthAn estimated 3 million
peopleperyearareaffectedwithfalciparum malariainAfghanistan, the most
dangerous form of the disease,accountingfor some20% ofcases.
Cutaneous Leishmaniasis is adisfiguringskindiseasetransmittedbya sandfly that affects thousands ofpeopleinAfghanistanperyear.
Pre-positioning of rapid malariadiagnostic testsandmedications inseveralsites.
Thestudy demonstrated thatmalariawasa common illness during thetransmissionseason.Mildanemiawasalsocommon(12%ofthepopulation)falciparum infections just one of thecauses. Coverage of insecticidetreatednets(ITNs)waslow,less than10% of households below 1500maltitudepossessed ITNs.
WHOcontinuedtosupportthenationalmalaria & Leishmaniasis controlprogramtechnically and financiallyin2003.
Prioritiesfor2004
Malaria & Leismaniasis
Bu c k e t s of wa te r onchildren’shandsandheads,being trembled from onestreet to another is stillcommoninAfghanistan.
Inadequate quality of water andinappropriatesanitationaccountformorethan 80% of diseases in developingcountries CurrentlyAfghanistanhasthelowest water supply and sanitationcoverageintheworld.Only24%ofthepopulation has access to safe drinkingwater,and12%toadequatesanitation.
The lack of proper water supply andsanitation service coverage rates inAfghanistancoupledwithothernegativeconditions areattributed to an under 5-mortality rate of 25.7 %andaninfantmortalityrateof16.5%.
WHO Afghanistan initiates andimplements numerous activities rangingfromtheconstructionofwatersuppliesinnumerous cities (Faizabad, Jalalabad,Kandahar, Ghazni, Kunduz,Mehterlam,andCharikar), thechlorinationof watersources,thepurchaseofequipmentsandthe training of staff to improve waterqualityandsanitation.
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Chlorinationofwater sources in Kabulhelpedcontrolandcombatcholerainthecity; latrines constructed in Kandahar,Faizabad, and Kunduz promotedadequate sanitation and reduced theburdenofdiseases.Waterbornediseaseshavebeenreducedasaresultofprovidingsafe drinking water through a pipednetworkinFaizabad. Thesamewillbereplicated in Kunduz, Charicar andMehterlam.
All water supply projects requirematerialsandequipment,likegenerators,pumps,pipesand fittings. Funding forthese equipments are from extrabudgetary sources. The Japanesedonationwillimprovewatersupplyandsanitation for IDPs and AGFUND’scontribution will buy water qualitytestingequipment.
Selected Technicians from MoPH andcentral authority of water supply andsewerage are trained on water qualitytesting using water quality equipment
procuredandinstalledbyWHOAfghanistan.
The Community Water & Sanitation unitorganized15trainingcoursesontheinter-relationamongwater,sanitationandhealth,environmental health, water supplyengineering, water quality testing, watersurveillance, food safety and low-costtreatment methodologies of waste-waterdisposal/treatment.
WHOstaff workfromwithintheministryofpublic health maintaining a close workingrelationship with the counterparts in anattempt to enhancetheircapacity. Nationalauthorities are being trained on how tooperate and maintain projects aftercompletion.
50 educators were trained to disseminatehygiene education messages to promote
hygiene awareness among Kabulis.Strategies included house-to-house andschoolvisits.
WHOoffereditssupportthroughout2003totraining of staff on chlorination of watersources inJalalabad,Kunduz,andKandahar.
In2003 WHO supported and managed thechlorinationandhygieneeducationprogramfor choleracontrol inKabulin partnershipwithUNICEFwhich providedthe chlorine.WFP supplied food for work, and theMinistry of Health assigned staff thatmonitoredandsupervisedtheentireprocess.Thelatestcampaignwasjointlylaunchedby
all stakeholders in August to chlorinate17,500shallowwells.
The Kunduz water Supply Project wassuccessfullyterminatedendofOctobertothereliefofitsresidentswhowereservedby highly polluted surface water andshallow well waters. The projectrehabilitated existing wells used as watersource for drinking water, distributionreservoirs, transmission pipes, the oldwater supply system of Kunduz city,existingpublicstandposts; installednewones, constructed a pump house andgeneratorhouses.
Theprojectalsoincludedahealth/hygieneeducationcomponent.
Strengthentheprogramforwatersupplyand sanitation systemsthrough programsupport
Contributetoexistingwatersupplyandsanitationprojects
FormulateEnvironmentalHealthpolicy
Developplansandstrengthenedprogramsforlowcostsanitation
Raise public awareness on thee n v i r o n m e n t a l h e a l t h r i s k s .
P r o c u r e m e n t o fequipments&materials
Capacitybuilding
Kabul Water sourcechlorination
Rehabilitation of theKunduz Water SupplyProject
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Water & Sanitation
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Major achievements2003
Priorities for 2004
Mental health resourcesand support to the illaremeagerinAfghanistan.
According to the WHO project Atlas,there are onlyeightpsychiatrists for apopulationof25million.
The limited number of health facilitiescompounds the shortage of mentalhealthcarepractitioners.Thereareonlytwo mental health facilities with 80psychiatrybeds.
In2003WHOplacedaspecialemphasison building the capacity of Primaryhealth care doctors, nurses, clinicalpsychologists and Community healthWorkers.
WHO helpedthegovernmentformulatepolicies and guidelines, whichacknowledgementalhealth.
WHOprovidesa3-phasictreatmentfordrug add ic t s , which involvesmotivation,detoxificationandaftercare.
Self-helpgroupsforex-drugaddictsand
grouptherapyforadults and children addtothesupportprovidedbyWHO.
A1997Unicefstudyassessedtheaffectsofthewaron Afghans.Thestudyconductedon300hundredchildreninKabulshowedthat “40% of children lost their parents,twothirdshadseendeadbodiesorpartsofbodies, 90% believed thattheywoulddieduringtheconflict”.
Commondisorders foundin patients aredepression, anxiety, stress, psychosis andsubstanceusedisorders.
National health policy developed inwhichmentalhealthwasrecognizedas apriority
BasicServicesPackage(BSP)developedin which mental health is one maincomponent
Treatmentprotocolsfor commonmentaldisordersdraftedforinclusioninBSP.
Establishment offourcommunitymentalhealthcentersestablishedinKabul
Three-stagetreatmentschedulesetup fordrugaddictsinmentalhospital
Mental healthunitconsidered under theMinistryofHealthPrimary Health Carenew structure
Strengthen the administrative unit ofmentalhealthatthenationallevel
Rehabilitate the existing and orpreviously functioning institutions andservices, and provision of necessarysupplies
Addresstheneedsofmostsevereandalsochronicpatientsand vulnerablegroups
Integrate mental health components todifferentlevelsofgeneralhealthservices
Humanresourcesdevelopment.
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Major Achievements2003
Prioritiesfor2004
Mental Health
Laboratory Rehabilitation
Health Communication
ThisyearWHOplayedakeyadvisoryrolein accelerating the reform of theInformation-Education-Communication(IEC) Department of the Ministry of
Health.WHOcollaboratedwithUSAIDandvariousother partners to enhance the organizational,technical and managerial capacity of the IECdepartment.
This exercise will empower the Ministry in theplanning, design, implementation, as well asmonitoring and evaluation of multi-disciplinarycommunicationprograms in Afghanistan.
Attheoutsetof2003,anoverallassessmentoftheworkings of theIECDepartmentwasconductedtodetermine the - gaps and objectives - focus of therestructuring effort.Asaresulttwomajorprioritieswere set: devising and implementing a capacitybuilding plan and a comprehensive healthcommunicationstrategy.
The USAID/REACH capacity-building programwas designed to increase health communicationknowledge andskillsof MOH staff, primarily, butwillbenefitotheragenciesworkinginthefieldatthenationallevel.
TheIECstrategywasdevelopedduringa,WHOandUSAID/Reachworkshopwith allstakeholdersearlyinOctober2003.Participants, fromthepublicandNGOsectors,wereledthroughthestepsofdevisinga communication strategy framework, fromsituationalanalysistomonitoringandevaluation.
The strategy sets goals, objectives and designsapproaches to unify the behavior change andcommunicationeffortsupportinghealthprogramsatthe national level and across all sectors- Public,PrivateandNGOs.
Aparticipatoryapproachinvolvingallstakeholderswaspromotedinthedevelopmentofthestrategy, toensureconsensusalongtheprocess.
The endorsement and the implementation of thisstrategy bytheMinistryof health willconstitute aparamount step in the realization of preventionobjectivesrelatingtothehealthprioritiesoutlinedintheNationalHealthpolicyforAfghanistan.
Assisted in the development of “Guidelines forHealthMessages,”translatedintoDariandPashto.
Sponsored and provided technical support toMinistry of Health(MOH)forahealtheducationcampaign against diarrheainKabulCityfeaturingradiospotsandcommunityoutreachactivities.
Continuedsupporttotheproductionofaprogramaradio drama with BBC, “New Home-New Life,”containinghealthmessagesonvarioussubjects.
Worked withWFP andtheMOHontheNationalDe-worming HealthCommunicationCampaigntochange behaviors relating to the infection withwormsamongschoolchildrenages6-12years.
Collaborate with USAID/REACH and MOH, aswell asotherpartners, tofinalizethedevelopmentand implementation of a 3 year National IECStrategy
Collaborate with USAID/REACH and MOH, aswell as other partners, to develop policies andworkplansfortheIECDirectorate
Increase the capacityofpartnersandstakeholdersinthepublic,privateandNGOsectortoimplementtheNationalIECStrategyatcentralandprovinciallevels
Assist in the integration of health education intoprimaryandsecondarynationalschoolcurriculums
Design and implement evidence-basedintegratedhealthcommunicationcampaignstosupportWHOprograms in reaching their behavioral goals(including strategies, materials, media plans,monitoringandevaluation)
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MajorAchievements
Priorites for 2004
Facts & Figures on Afghanistan
WHO-Afghanistan
House N o.249,St.No.10Wazir Akbar Khan
Kabul, AfghanistanTel: 993-3-61-963
E-mail:[email protected]
ApublicationofthePublicInformationUnit
TheWorldHealthOrganizationOffice
forAfghanistanbasedinKabul,has
eightsub-officesthroughoutthe
country,employingmorethan250
national&internationalstaff.
DEMOGRAPHIC, SOCIO-ECONOMIC, AND HEALTH INDICATORS
Indicators Year Value Reference
DEMOGRAPHYTotal area (in thousandsq. km) 1972 636.3 Afghanistan GazetteersPopulation (in millions) 2002 25 UNDPPopulation per sq. km 2002 39 CalculationPopulation growth rate (%) 2002 3.3 UNDPUrban population (25%of total) (in thousands) 2002 6,250 CalculationTotal fertility rate 1998 6.9 WHOReport, 1999CBR (crude birth rate per 1000 population) 1995 48CDR(crude death rate per 1000population) 1995 28
WHO, 1997
SOCIO-ECONOMIC INDICATORS1. P. C. GNP(inUS$) 1990 180 MOPH, 19902. Adult literacy
2.1 Adult literacy Total (%)2.2 Adult literacy males (%)2.2 Adult literacy females (%)
2002 365121
UNDP
3. Life expectancy at birth3.1 Life expectancy Total (yrs) 2002 46.6 UNDP3.2 Life expectancy males (yrs) 2002 47.32 UNDP3.3 Life expectancy females (yrs) 2002 45.85 UNDP
HEALTH STATUS4. Maternal mortality rate (per 100,000 live births) 2002 1,600 UNDP5. Under 5 mortality rate (per 1,000 live births) 2002 230 UNDP6. Infant mortality rate (per 1,000 live births) 2002 155 UNDP7. Birth weight (%less than 2500 gr.) 2002 18 UNDP8. Acute malnutrition 2002 6-16% UNDP
HEALTH SERVICES COVERAGE:
1. Immunisation1.1 DPT3 (%infants immunised) 2001 451.2 Measles (%infants immunised) 2001 461.3 Poliomyelitis (%infants immunised) 2001 451.4 BCG(%infants immunised) 2001 541.5 All vaccines (% infants immunised) 2001 451.6 Tetanus (%of women in CBAimmunised
with at-least two doses of TT)2001 20
1.7 Total number of centresprovidingimmunisations
2000 546
1.8 Total %receiving Vitamin Asupplements 2000 95
WHO/UNICEFAfghanistan, 2001
2. Primary health care services2.1 %population covered Total 1997 352.2 %population covered Urban 1997 552.3 %population covered Rural 1997 25
WHO/UNICEFAfghanistan, 1998
3. MCHcoverage by trained personnel of3.1 % of pregnant women receiving maternity
care1999 12
3.2 % of deliveries attended by trained healthpersonnel
1999 15
3.3 % of deliveries attended by trained TBAs 1999 9
WHO Afghanistan, 1999
4. No. of hospitals’ bed per 10,000 population 2001 3.9
