OVERVIEW

Since 2003, Afghanistan has witnessed significant progress in the health sector. In spite of these gains, mortality rates for Afghan women and children remain much higher than the rest of the world, in part due to the limited use of birth spacing and family planning services. According to UN Inter-agency Group for Child Mortality Estimation, Afghanistan was ranked 185 of 201 countries on child mortality in 2013, and pregnancy-related causes of death remain the leading risk for women in their child-bearing years.

USAID is addressing these disparities through the HEMAYAT project. The project is implemented in partnership with the Ministry of Public Health at the national level and in 23 provinces where maternal, newborn, and child morbidity and mortality is high and utilization of maternal and child health services is low. The project will deliver high-impact health care to families in rural and difficult-to-reach areas in Badakhshan, Badghis, Baghlan, Balkh, Daykundi, Faryab, Ghazni, Ghor, Helmand, Herat, Jawzjan, Kapisa, Khost,Kunar, Laghman, Nangarhar, Nimroz, Nuristan, Panjsher, Paktika, Paktya, Takhar, and Zabul.

ACTIVITIES

• High-Impact Interventions: Scaling up high-impact interventions (HIIs) concentrated around “better care on the day of birth”.
• Capacity Building: Systematically building capacity of providers, the MoPH and professional organizations.
• Task-shifting to Community Health Workers (CHWs): Supporting CHWs to provide an integrated package of HIIs through task-shifting.
• Gender-sensitive Approach: Strengthening integration of gender and respectful care in Family Planning/Maternal, Neonatal, Child Health (FP/MNCH) guidelines and protocols.
• Establishment of Innovations Fund: Increasing access, utilization, and demand for health services through establishment of Innovations fund.
• Integration of Family Planning and Gender: Ensuring integration of Family Planning and gender equity throughout the Maternal, Neonatal, Child Health (MNCH) continuum of care.

ACCOMPLISHMENTS

USAID invests in activities that deliver quantifiable results. The HEMAYAT project:

• Supported the MoPH to develop a national scale up plan for distribution and utilization of chlorhexidine for newborn umbilical cord to prevent sepsis.
• Supported the MoPH to develop the national scale up plan for prevention of Postpartum Hemorrhage (PPH) through use of misoprostol.
• Assisted the MoPH to ensure inclusion of the long acting reversible contraceptive, the implant, into the Essential Drug List (EDL) and provided refresher trainings for Postpartum Intrauterine Devices of national trainers.
• Worked with the MoPH to adopt the WHO package for Youth Friendly Hospital Services (YFHSs) for Afghanistan.
• Revised the Harmonized Quality Improvement Program (HQIP) maternal, newborn and child health standards and formed provincial quality improvement committees.
• Released first innovation fund call for applications and received more than 200 concept papers proposing innovative concepts for health care improvement.