The World Bank’s International Development Association (IDA) Grant aims to help the government of Afghanistan’s Ministry of Public Health (MoPH) expand the scope, quality and coverage of basic health and essential hospital services. SEHAT will cover both rural and urban areas in 22 of the country’s 34 provinces. It will also strengthen the national health system and build the capacity of the Ministry of Public Health to effectively perform its stewardship functions at the central and provincial levels.
“Provision of health care to its people remains one of the main priorities of the Government of Islamic Republic of Afghanistan during the transition” said HE Dr. Omar Zakhailwal, Finance Minister, Islamic Republic of Afghanistan. “While we have had significant improvements in access and quality of health care in Afghanistan over the last decade, more needs to be done. We are grateful to the World Bank’s contribution in this regard.”
SEHAT follows two earlier projects financed by the World Bank. With this new financing, the World Bank has provided a total of $335 million since 2003 including support from the Afghanistan Reconstruction Trust Fund (ARTF). This funding would be further supplemented by a proposed ARTF funded grant of $270 million including European Union and Government contribution of $30 million.
Over the past decade, Afghanistan has made steady progress in the health sector. The number of health facilities in 11 target provinces nearly tripled from 148 to 432. Around 20,000 community health workers—half of them women—were trained and deployed throughout the country, increasing access to family planning and boosting childhood vaccinations. The number of facilities with trained female health workers rose from 25 percent before the project to 74 percent today. At the same time, the number of functioning health facilities increased from 496 to more than 2,000. These interventions have produced significant improvement in the coverage of reproductive and child health services, as well as a significant drop in maternal and child mortality.
“The World Bank’s support has been instrumental in enabling us to save the lives of hundreds of thousands of Afghans, particularly women and children,” said HE Dr. Suraya Dalil, Minister of Public Health of the Islamic Republic of Afghanistan. “Providing a basic package of health services and an essential package of hospital services has proved to produce encouraging results, particularly in remote and underserved areas. As we continue to deliver our commitment in expanding provision of health services to all Afghans across the country, we appreciate the World Bank’s assistance at this crucial period of the transition process”.
The above outcomes were possible because of the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) implemented by the Ministry of Public Health with support from international and national NGOs for delivery of health services across the country. SEHAT will expand to 22 provinces and continue to support these Services. As well as strengthen the capacity of the Ministry through modernizing systems, streamlining organizational structures, building a cadre of skilled and motivated staff and making hospitals more autonomous.
Despite recent progress, the country faces significant challenges in the sector. Afghanistan’s infant and under-five mortality rates are still higher than the average for low income countries, and child malnutrition rates are among the highest in the world. About 55 percent of children under-five suffer from chronic malnutrition and women and children suffer from high levels of vitamin and mineral deficiencies.
“The encouraging achievements in the health sector over the past decade were possible because of the Ministry of Public Health’s commitment to improving health services and measuring service delivery performance with assistance from its partner NGOs,” said Illango Patchamuthu, World Bank Acting Country Director for Afghanistan. “This new program will help ensure expansion of basic health and hospital services for both urban and rural areas where due to lack of such services thousands of people, particularly women and children, lose their lives every year. We believe these packages of health services we finance play a vital role in improving the health of Afghans.”
The Ministry of Public Health will implement SEHAT program over a period of five years.
In 2018, through SEHAT, Afghanistan aims to achieve the following outcomes:· 35% of births attended by skilled health personnel
- 60% of children aged between 12 and 23 months will be vaccinated against five vaccine preventable diseases
- 40% of pregnant women will have antenatal care coverage
- 50% of pregnant and lactating women would have received counseling on infant and young child feeding
- 15 national hospitals will have full budgetary autonomy