MSH Afghanistan continues to strengthen the capacity of the MoPH to ensure access to quality health services and currently supports 715 NGO-run health facilities that deliver a community-based, directly observed treatment short course (CB-DOTS) approach to TB in 15 provinces. The success of the CB-DOTS approach—still used today under the Challenge TB Program—has helped TB patients access and maintain essential treatment.

Highlights

• Recently engaged closely with over 4,400 family health-action groups in all 15 provinces to promote DOTS

• 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 increased the number of trained midwives in the country from fewer than 500 in 2003 to more than 1,300 in 2006

• 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