Afghanistan’s health system has been steadily progressing over the last 17 years, with increasing coverage of health services throughout the country. In 2018, a total of 3,135 health facilities were functional, which ensured access to almost 87% of the population within two hours distance. Afghanistan’s National Health Policy 2015-20 has five policy areas: governance, institutional development, public health, health services and human resources. The recently developed One UN strategy focuses on Health System Strengthening among other health topics. WHO and UN agencies are helping the government to implement the National Health Policy 2015-20 and Strategy 2016-2020.

Achievements

  • As co-chair of the Development Partners Forum, WHO provided technical support to MoPH and partners to strengthen policy dialogue, coordination and harmonization of programs in the sector, and the mobilization of resources.
  • Supported the development of a new health package for UHC.
  • Assisted in the formulation of a National Health Strategy 2016-20.
  • Helped the development of SEHATMANDI (2018-21).
  • Supported the establishment of a Health Sector Strategic Oversight Committee, chaired by H.E Minister.
  • Supported the development of a fourth round of National Health Accounts.
  • Established and strengthened the first Afghan Medical Council.
  • Strengthened the National Medicines and Health Regulatory Authority.
  • Implemented the patient safety program in 17 hospitals.
  • Updated the National Medicine Policy and National Formulary of Medicine.
  • Formulated the  National CRVS strategy and facilitated development of tools for the implementation of ICD10 at hospital level.
  • Established mobile health teams (MHTs) in 12 provinces to provide nomadic populations with better access to basic health services.
  • Established the Public Private Partnership (PPP) model to provide basic reproductive health and immunization services in remote and insecure districts of six insecure provinces.
  • Supported the establishment of a public-private partnership for upgrading 142 private health facilities in insecure areas. The health facilities provide basic maternal and child health services, including immunization.
  • Established a call center to support individual concerns on health issues.
Health facility typeNumber
Sub-centre986
Basic Health Centre873
Comprehensive Health Centre432
District hospital84
Provincial hospital27
Regional hospital9
Special hospital30
Mobile clinic242
Other452
Total health facilities3135
Health posts17297

Program risks and challenges

Sub-optimal utilization of services due to poverty and distance to health facilities.Inadequate access to priority health services due to distance, high cost, low awareness, insecurity and shortage of female health care providers.Reduced donor support for the health sector beyond June 2018.Inadequate domestic resource allocation to health.Low level of execution capacity particularly at the sub-national level.

Way forward

WHO with MoPH and key partners have identified health system development as one of their key priorities, including support to: implementation of the National Health Policy and Strategy, revision of BPHS/EPHS and development of minimum package of health services for Universal Health Coverage, government leadership and regulatory role and integrated health service delivery in line with Sustainable Development Goals (SDGs) and Afghanistan National Peace and Development Framework.