CHAP preparation 2014 November 2013

1. CHAP preparation 2014 November 2013 ____________________________________________________

2. Needs analysis Used same indicators as for 2013 and results have been comparable • Very high: Helmand, Kandahar, Badhis, Paktika, Ghor and Nuristan • High risk provinces: Nangarhar, Kunar, MaidanWardak, Paktya, Uruzgan, Nimroz, Bamyan and Daikunki • Around 106 districts are identified as high and very high; people in need close to 2.8 million and targeted 2.4 ____________________________________________________

3. Needs – programmatic areas • Access to critical health services in areas affected by conflict and insecurity; closure of HF, suspension of outreach and mobile activities; difficult population movements (security, affordability), weak preventive activities) - > morbidity and mortality • Trauma care : increased needs , declining capacity • Early warning and response to outbreaks and natural disasters ____________________________________________________

4. CHAP objectives (drafts) • Protection of civilian as per broader definition (not only civilian casualties) • Strengthen the health services for communities affected by conflict through improved access to critical emergency services including trauma • Protection of IDP and returnees who are recently displaced

5. Health sector response plan (draft) • Objective 1: • To ensure access to critical health services for people affected by conflict and not covered by the Basic Package of Health Services. Output 1 a) Emergency integrated PHC services to address the immediate health needs of 1.3 million conflict affected people not covered by BPHS. Output 1 indicators; • Number of temporary fix and mobile health units providing comprehensive PHC services including treatment of common diseases, MNCH, FP, EPI, free of charge medication, nutrition, HP, and referral. Target 100 HFs

6. Response plan • Percentage of HF having qualified female staff – Target 80% • Number of health facilities with Basic emergency obstetric care services /500,000 pop /administrative unit Target 4/500,000 population Objective 2: To ensure timely access to stabilization, referral and treatment services of civilian war casualties in provinces and districts identified at high risk. Output 2: Effective mechanism for trauma management at all levels of health care system is functioning in high risk provinces/districts for timely treatment of war casualties

7. Response plan Indicators: • 20 FATP and 48 PHC facilities in 13 high risk provinces able to stabilize, treat and refer war trauma cases • 26 provincial and district hospitals have adequate capacity (mass casualty management plan, medicines and supplies, ancillary services (ambulances, blood bank) for treatment of civilian casualties. • Two specialized trauma hospitals for treatment of severe cases are functioning (Kabul and Helmand)

8. Response plan • Target: 230 health professionals trained • Community based first aid and triage in risk areas: Target; 30 districts Objective 3: To timely and effectively address the health needs created by acute onset emergencies that surpass the local response capacity, including population displacements. To be integrated into Obj 1

9. Response plan • Output 3.1 Availability of the necessary supplies and operational inputs to cover the health response to acute onset emergencies, including recent/new IDPs, returnees and informal settlements Target 400,000 people (IDPs/returnees and Informal settlements around 200,000) Objective 4: To maintain and effective early warning and response mechanism to outbreaks of communicable diseases that surpass local response capacity.

10. Output 4: • Excessive mortality and mortality is prevented through prompt investigation and response of alarms of potential outbreaks based upon effective early warning and adequate surge capacity. • Indicators • 100 % investigated and response initiated within 48 hours from notification • CFR – maintained within international standards