MSH Afghanistan continues to strengthen the capacity of the MoPH to ensure access to quality health services.

Highlights

• Supported 15 provinces (covering 65% of the country) in improving universal access to TB services using the successful community-based, directly observed treatment short course (CB-DOTS)

• Used community-based case-finding approaches such as CB-DOTs and contact screening to diagnose over 156,000 TB-positive patients from 2014 to 2018

• Supported the decentralization of diagnostic services and the introduction of rapid diagnostic technology to support TB case finding through the procurement of 30 GeneXpert machines. Trained over 50 local laboratory staff on the machines and GxAlert software in 15 provinces. From 2015 through 2019, 43,800 tests were run on the GeneXpert machines and 16,295 (46%) people were notified of their TB-positive status

• Assisted the National TB Program (NTP) in diagnosing and treating over 490,000 TB patients with a treatment success rate of 92% 

• Supported the development of policies, regulatory frameworks, and strategies and helped mobilize more than 22,000 volunteer community health workers (half of them women), as part of developing the MoPH’s Community-Based Health Care Unit

• Supported the MoPH in developing and implementing a Health Information Strategic Plan and in providing training to more than 2,000 Afghans in a Health Management Information System (HMIS), data use and quality, and national surveys to strengthen their ability to effectively capture, manage, and use data to drive decision making (these measures helped increase the HMIS submission rate from a mere 5% in 2003 to 90% in 2011)

• Assisted the MoPH in bringing a community-based family planning program to scale, thereby increasing the contraceptive prevalence rate from 26% in 2006 to 37% in 2011

• Collaborated with the MoPH and other stakeholders to implement a package for competency-based education of two types of midwives, one group to serve at community-level health facilities and a second to serve in hospitals; this effort has more than doubled the number of trained midwives in the country

• Supported the development of stock management standard operating procedures for pharmaceutical enterprises and refurbished the MoPH Central Medical Store to promote good storage practices; the average availability of medicines in associated health facilities in 13 provinces increased from 89% to more than 93% in 2015

• Helped establish a National Drug and Therapeutics Committee to improve oversight and implementation of rational medicine use strategies and supported similar committees in 17 national and provincial hospitals; also promoted the development and use of national standard treatment guidelines

• Conducted at least one supportive supervision visit at nearly 800 facilities, focused on improving pharmaceutical supply management and rational medicine use; antibiotic prescribing to outpatients in these facilities decreased from 51% in 2012 to 41% in 2015