The Afghanistan National Health Resources Assessment (ANHRA)
From July to September 2002, Management Sciences for Health, with funding from the United States Agency for International Development (USAID), the European Commission, the United Nations Population Fund (UNFPA) and the Japan International Cooperation Agency (JICA), trained and dispatched more than 160 male Afghan nationals to survey 1,038 health facilities, 2,915 community-based health providers, and 1,445 pharmaceutical outlets throughout Afghanistan. The goal was to develop an accurate picture of available Afghan health services and health professionals. The Afghan Ministry of Public Health and its partners used the resulting data to establish a foundation for equitable access to a basic package of health services, with a particular focus on Afghan maternal and child health.

The report can be downloaded through the link below as a PDF file. The file size is 4.2 MB, and download may take a long time depending on your Internet connection speed. Once the file is opened, you can use the bookmarks in the left pane to navigate the content. You can also use links in the table of contents to bring you to the corresponding chapter, or references to annex tables under the section titles to bring you to corresponding tables in the annex. To return to your previous location in the document, right-click and select "Return to previous view."

Given the size of the report, print versions are not available. Download final report [PDF-4.2 MB]

Please note that the data used for the preparation of this report reflect the ANHRA database as of December 2002. This database is updated as new information is obtained and available information is reviewed in greater detail. The report reflects the major findings, and illustrative tables are included in the annex. Updated tables and more detailed analysis are available upon request from the Afghanistan Ministry of Public Health, Health Management Information Systems section (in Kabul) by contacting moh_hmis@yahoo.com.

Afghanistan National Hospital Survey
MSH's European affiliate, MSH Europe, assisted the Afghan Ministry of Public Health in undertaking a national hospital assessment in late 2003. This follow up to the 2002 National Health Resource Assessment was supported by the European Commission, USAID, JICA, UNFPA, the French Development Agency and French Ministry of Foreign Affairs.

Afghan government surveyors and supervisors were engaged and trained to assess 117 public sector hospitals identified by the Afghan Ministry of Public Health. Based on survey findings, a global view of the respective position of Afghan hospitals was developed based on technical indicators which are considered to be the necessary and vital elements for hospitals to function normally (access to power and water, sanitation, communication, transportation and infrastructure).

For each of these elements, a cluster indicator was calculated, facilitating comparisons across hospitals. A picture of the functionality of health care units, designated as priority by the Afghan Ministry of Public Health, was established to determine whether the units that were assessed met the required conditions for delivering the expected services. The functionality indicator for health care units comprises several components: infrastructure, human resources (HR), equipment, access to water and power and availability of drugs and consumables.

Key findings included:

• Poor distribution of hospital facilities with the population of some Afghan provinces having little or no access to acceptable hospitals
   
• A low number of hospitals and hospital beds in Afghanistan compared with other countries having similar levels of income
   
• An acceptable physical condition but serious shortcomings in supplies of water and electricity
   
• Afghan Hospitals are under-equipped and equipment is not adequately maintained
   
• Afghan Facilities are under-utilized and over-staffed
   
• Delivery and emergency obstetric care are particularly poor in Afghanistan; very few facilities can provide safe Caesarian-sections

Final report is available for download. Please note—due to the size of this document, it has been divided into six parts for downloading.