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The Purpose of the Presentation:

Technical Consultation on the role of Community-based Health P roviders in Improving M aternal and N ew-born H ealth Country Presentation-Afghanistan Dr. Said Habib “ Arwal ” MD, MA of Apply Community Health, Change and conservation National MoPH /CBHC Coordinator

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  1. Technical Consultation on the role of Community-based Health Providers in Improving Maternal and New-born Health Country Presentation-Afghanistan Dr. Said Habib “Arwal” MD, MA of Apply Community Health, Change and conservation National MoPH/CBHC Coordinator Amsterdam, Netherlands, May 30-31, 2012

  2. The Purpose of the Presentation: • The role of Community Health Workers (CHWs), in the continuum of care for Maternal and Newborn Health (MNH); • The policies, actual practices and possible contradictions between policy and practice; • Evidence of what works well in interventions involving CHWs; • Dilemmas identified and lessons learned from implemented programs involving community based providers of MNH • Opportunities and directions for implementing interventions at scale and gaps in knowledge

  3. Afghanistan the Heart of Asia and Middle East

  4. Demographic Situation • Population of Afghanistan is around 25 millions • Sex ratio is 105 males per 100 females • The percentage of Afghans that is not able to meet their basic needs 36 percent . • Male illiteracy is at a level of 61 percent and female illiteracy at 88 percent Health Indicators in Afghanistan ? • One most internationally comparable health indicators, Afghanistan is among the worst performing countries . • Maternal mortality ratio 327/100000 live births • Child under 1 mortality 77/ 1000 live birth • Child under 5 mortality 97/1000 live births • Life expectancy rate is 62 year • There are 406 thousand disabled persons in Afghanistan • Access to any public Health facility within one hour waking is possible for 60 percent of the population • High maternal and child mortality due to preventable causes is one of the major public health problem in Afghanistan which needs extensive consideration • Afghanistan officially has 636 cases of HIV

  5. Introduction to CBHC in Afghanistan • CBHC stands for Community based Health Care. CBHC is not a new concept in this country. It existed prior to many years of war and conflict in this country. However, the current CBHC was incepted along with BPHC (Basic Package of Health Services) in 2002 as service delivery policy at the community level. • During 2003-2005 only CBHC TF was established in MoPH, • in 2005 for the first time CBHC Department was established in MoPH, included in its official organ gram • CBHC was Able to strengthen the CBHC TF as now it is one of the top TF in MoPH, CBHC tray to standardized the documents. • In 2008 have started implementation of PPFP project of USAID and because of this project all relative activities relation , coordination is strengthened. CBHC is recognized as a leading department of the MoPH ,empowering communities to have a strong sense of ownership of their community-based health program, promote their health status, and achieve a sense of well-being.

  6. Updated CBHC Data

  7. Community-Based Health Care System, Afghanistan Female & male CHWs Referrals/Reporting Other influential people Family Health Action Groups Outreach COMMUNITY Health facility Support Private providers Community Development Council (CDC) CHS Facility Shura-e-Sehi Community HP Shura-e-Sehi VDC

  8. CHW Training on Community Map

  9. CHW administers DMPA injection to a FP Client

  10. CHWs and provision of health services

  11. Community Health Workers (CHWs) Community Health Supervisors (CHSs) Shura-e-Sehi (Community Health Committee) Family Health Action Group (FHA Group) Family Health Worker (FHW) ……………………………… Piloting of Future Health Service 2FHS2/ CSC Joint project(MoPH/JHU). Family Health House FHH /Community Midwives

  12. As CBHC is Foundation for Public Health / MoPH_BPHS, it should be strongly supported by all Stakeholders including Donors and UN-Agencies; • Keeping of the present team of CBHC • Proactive and regular supervision and monitoring of CBHC program; • Scaling up community based interventions such as FHH and PPFP project in their provinces. • Advocacy for MoPH/CBHC program at National and International level; • Shearing of CBHC Afghanistan’s Achievements and Learning from others • experience during all International relatives meetings, conference . • Strengthening referral system between community based interventions HPs, FHH etc and higher level of HFs; • Insure the quality of services at CBHC level by developing standards; • Insure regular supply

  13. Thanks from KIT in providing us with this opportunity to attend this event and thanks for your Attention! Any questions?

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