Afghan Health & Development Services
A nonprofit, 501(C)(3), Tax ID: 54-1968322 committed to helping the Afghan people. Established in 1990.

For a healthy society


Recent Annual Report 

For the full report in PDF version click on Annual Report 2019

 

SDG 

AHDS’ theory of change describes how to ensure universal health coverage (UHC) and the right to the highest attainable level of health. Based on the new strategic plan, AHDS services contribute to the sustainable development goals (SDGs) 2, 3, 4, 5, 6, 8, 13, 15 and 16.

 



Projects in 2019

Humanitarian aid

The Health and Nutrition project for drought affected people in Uruzgan Province is aimed to improve the wellbeing of the general population affected by drought through improved access to basic health and nutrition services targeting IDPs, returnees, and vulnerable host communities in the districts of Uruzgan Province during coming 6 months. The project is funded by OCHA-Afghanistan Humanitarian Fund (AHF).

Community Development

Citizens’ Charter National Priority Program (CCNPP) is facilitated by AHDS&SDO joint venture that supports the communities and their elected Community Development Councils (CDCs), extending from community mobilization to full utilization and monitoring of their block grants in Uruzgan and Zabul.The project is funded through MRRD by the World Bank (IDA). AHDS facilitates the Uruzgan part. 

Targeted Supplementary Feeding Program (TSFP) was supporting the Health and Nutrition project for drought affected people in Uruzgan Province. The aim was to treat acutely malnourished children, and pregnant and lactating women in Uruzgan. It was funded by WFP.

Social Inclusion Grants (SIG) as part of CCNPP, SIG is a pilot sub-program, to mobilize the communities and their CDCs stop seasonal hunger by establishing a simple safety net for the poorest in Uruzgan Province.  

Malaria control

AHDS partnered with UNDP to control malaria in Uruzgan. It was part of the Strengthening and Scaling-up Malaria Prevention and Case Management to improve Health Status in Afghanistan  financed by the Global Fund.

Advocacy for Health

Objective of the Lobby and Advocacy for Health Trajectory is to convince decision makers to support and endorse the resource mobilization reforms for increasing domestic investment in health is organized around four key areas: 1) Increased allocation of government funds to health, 2) Earmarked tax (sin-taxes on tobacco, vehicle, fuel, sugary-sweetened beverages) for health, 3) Collection of user fees at hospitals and 4) Introduction of health insurance. The project is funded by Cordaid.

 

Results

2019

 

Outpatient consultations

Psychosocial consultation and

Health education

Children fully immunized

Malnourished children treated

55,393

8,970

2,209

4,387

Pregnant women received antenatal care

Pregnant women immunized against tetanus

Deliveries by midwives

Health facilities functional

1,477

669

232

12

Armed conflict injuries stabilized

Mental health disorders

Malaria cases treated

Attendants in short courses

821

768

1,306

2,525

Community Development Council (CDC) established

Community Development Plans (CDP) developed

Well Being Analysis (WBA) completed

Social Inclusion Grant (SIG) implemented

30

24

24

26

Sub-Committees established

Cluster CDCs established

Trainings for CDC and Sub-committees

Community Monitoring

26

10

60

58



Humanitarian aid

 

The Health and Nutrition project for drought affected people in Uruzgan Province aimed to improve the wellbeing of the general population affected by drought through improved access to basic health and nutrition services targeting displaced people, returnees, and vulnerable host communities in the five prioritized districts of Uruzgan Province. Duration was six months supported by UNOCHA; Afghanistan Humanitarian Fund (AHF) allocation.

The services were provided by eight Sub Health Center (SHC) in white areas and four mobile nutrition teams.

·       Essential live-saving trauma care including through rehabilitative care and psychosocial support in emergencies.

·       Primary healthcare services with focus on maternal and child health.

·       Support existing 14 BPHS health facilities, which did not have nutrition services.

·       Integrated Management of Acute Malnutrition (IMAM) for children 6-59 months, pregnant and lactating women.

·       Infant and Young Child Feeding promotion and counselling and micronutrient supplementation for children 6-59 months, pregnant and lactating women.

·       Protection services to women, men, girls and boys; referrals and psychosocial support to conflict affected people.

·       Winterization support (extra medicines and medical material) for existing 23 BPHS health facilities that were overloaded with increased patients.

Mr. Abdulla Jan from Khas Uruzgan: Shinie Village is out of government control and very far away from the big cities. We did not had any health facility as I remember in the past 40 years. The patients had to travel long distances to Daikundi or Ghazni provinces. AHDS established a Sub-Health Center (SHC) here that solved our problems. The community members were very happy and cooperating in terms of security of the clinic and its staff, animal transportation for the supplies and 50% discount in rental house for the clinic.

Unfortunately, duration of this emergency health and nutrition service project was only six months. We hope that the clinic will resume its services once again, since health problems are endless in the communities.

 

 


Health and Nutrition

 

 Mr. Abdul Samad from Charchino District, Uruzgan: I got fever and general body pain two week ago. I purchased some medicines from nearby pharmacy, but no response. Then I took medication from another pharmacy that also not relieved my fever and pain. A friend advised me to go to Khod Sub-center. The in-charge nurse took my blood for rapid diagnostic test (RDT), which showed malaria. Fortunately, I recovered in few days and advised other villagers to use this health facility as well.

The health facilities and mobiles served 55,393 outpatients including mental health consultations for 768 people. The injuries by armed conflict were 288 cases. Health education and psychosocial consultation covered 8,970 people.

Midwives attended the pregnant women; antenatal care reported 1,477 and postnatal care 970 visits. Institutional deliveries were 232 newborns. Integrated management of acutely malnutrition treated 4,387 children. Screening was done in the villages by CHWs and at the health facilities by the nutrition counselors, nurses and midwives.

All the cases of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) were treated in the outpatient therapeutic program (OTP).

Ready to use therapeutic and supplementary foods (RUTF and RUSF) were the main treatment regime. The cure rate was 91 for SAM and 84% for MAM suffering children. The rate for defaulters of the program was very low at 0.5%. The deaths were kept low to only one child during six months of the project.

Using the opportunity, 2,209 under two children and 669 pregnant women were fully immunized (by the routine vaccines). 

The health facilities and community health workers identified 1,306 suspected malaria cases, out of them 10 malaria cases confirmed with rapid diagnostic tests (RDT).

Advocacy

 

Afghanistan’s health system is heavily financed by international donors and private household expenditure. Approximately 75.5% of total health expenditure (THE) was paid by households’ out of pocket (OOP), about 19.4% by international partners and only 5.1% by the government of Afghanistan (NHA 2017). The high OOP expenditure has resulted in a substantial financial burden on households.

In Afghanistan, input from domestic sources is only US$ 3.4 while the average total health expenditure per capita is about US$ 87. According to the national budget decree 1399 (2020), the government allocated only 3.4% to the health sector. The share of the government allocation to the health sector is far lower than the Abuja Declaration targets that recommend 15% for underdeveloped countries.

The ministry of public health (MoPH) proposes following strategies for increasing domestic investment in health:

1.     Increased allocation of government spending on health; reduce dependency on external aid.

2.     Earmarked taxes for health (sin-taxes*); reduce and treat hazards.

3.     User fees management at hospitals; improve quality of secondary and tertiary healthcare.

4.     Promotion of social health insurance; protect from catastrophic health expenditures.

 Increased revenue addresses the following priorities:

1.     Improve overall quality of secondary and tertiary healthcare.

2.     Improve treatment and research centers for cancer, non-communicable diseases and injuries.

3.     Train highly qualified clinical staff to meet the needs of the country and advances on health.

4.     Equip and modernize the hospital sector according to international standards.

5.     Implement demand and supply side interventions to increase uptake of primary healthcare services.

Therefore, AHDS with support of Cordaid as well as Health Economics and Financing Department (HEFD) of MoPH initiated lobby and advocacy for:

1.     Increase government budget allocation on health.

2.     Excise tax earmarking for health.

3.    Obligatory social health insurance.

As a first step, AHDS developed a one-pager showing current profile of healthcare financing in the country, what is global practice and what is needed to improve it. The one-pager was published in 3 languages (Dari, Pashto and English). Then, lobby and advocacy related training (theoretical and practical) and workshops were provided for the staff.

Orientation sessions were provided to the civil society organization, high authorities with the government, Parliament and Senate members, candidates of the Presidential elections, public health workers and private sector. In the parliament the two related commissions were targeted; Budget and Health. 

Two kind of video spots were developed and frequently broadcasted by TVs for promotion of social health insurance and sin-taxes increment.

Polio

 

Polio remains endemic in Afghanistan. The security situation remains very challenging.  Inaccessible and missed children particularly in the Southern Region represent a large cohort of susceptible children in this part of Afghanistan.  The risk of a major upsurge of cases is growing, with other parts of the country.

The approaches for polio eradication involves house-to-house OPV vaccination. It is done through national immunization days, subnational immunization days, responses to polio virus positive cases, mop-up and short-interval additional dose campaigns. Children aged <5 years are also targeted for vaccination along major travel routes at transit points and at border crossing points with Iran and Pakistan.

As a national concern, we urge:

·       Improved routine vaccination by the fixed centers and mobile strategy.

·       Quality training for vaccinators and volunteers.

·       Active community involvement.   

·       Quality of supply chain.

·       Target the exhaust due to frequent campaigns.

·       Research for causes of current strategy failure and alternative approach.

 

Community Development

AHDS in partnership with SDO is facilitating partner (FP) for the Citizens’ Charter National Priority Program (CCNPP) and Social Inclusion Grants (SIG) under pakage-1 in Uruzgan and Zabul provinces. This is a three-year project (May 2017 – May 2020) will possible extension for another 6 to 12 months.

Almost all the target communities are covered in Zabul, while in Uruzgan expansion of the program was very slow. The main challenge was lack of access to insecure areas.

Movement restrictions were imposed by both sides; the government forces and the opposition militants. AHDS staff had very hard times to convince them that it is a national program without any political agenda. Although, in principle both sides accepted expansion of the program, higher authorities promised full support; but unfortunately, practically their field staff continuously created problems.

We call upon the people of Uruzgan to defend their collective rights against the individual interests.  

Facilitating Partner

AHDS

SDO

 

Province

Uruzgan

Zabul

District

Tirinkot

Chora

Qalat

Tarnak o

Jaldak

Total

 

Target communities

197

216

191

126

730

Communities covered

100

17

185

113

415

Activities achieved in 2019

Community profile

32

 

 

 

32

Community Development Council (CDC)

29

1

98

19

147

Wellbeing analysis

24

 

108

47

179

Community development plan (CDP)

24

 

108

47

179

Sub-Committee

20

 

95

45

160

Cluster CDCs  

10

 

32

26

68

Procurement and finance workshop

16

 

60

37

113

Gender and environment workshop

60

 

177

113

350

Project risk and disaster management

62

 

182

113

357

Monitoring workshop

60

 

167

110

337

Social inclusion grant (SIG) proposal

26

 

 

 

26

Approved SIG proposal

26

 

 

 

26

SIG fund transferred

13

 

 

 

13

Amount procured (AFN)

2,720,000

 

 

 

2,720,000

SIG beneficiary families

258

 

 

 

258

Grain bank (GB)

 

 

100

15

115

Amount for food purchase (AFN)

 

 

1,572,642

262,636

1,835,278

GB beneficiary families

 

 

363

56

419

 

Ms. Gulalay Mohammad and Mrs. Zohra Tokhi, Parliament Members, have been very supportive for our two projects; Citizens’ Charter National Priority Program (CCNPP) in Uruzgan and the Lobby and Advocacy for Health Trajectory (financing).  AHDS take this opportunity to thank them for hard work and commitment.

 

Human Resource

AHDS could provide 109 job opportunities through its three projects in 2019; out of which 25% employees were female.

Capacity building opportunities provided for the staff and community members who were engaged in the community development councils. A total of 2,525 person including 1,410 males and 1,115 females participated in the trainings.

The main challenge was arrest of our staff by national security department as well as Taleban.

On the job training, internship, was provided for two females and one male admin/finance trainees.

Staff were provided with the following trainings:

  • Healthcare financing.
  • Barometer survey.
  • Risk management.
  • Procurement and finance management.
  • Gender integration in programs.
  • Vaccination.
  • Nutrition.
  • HMIS.
  • Reporting.
  • Disaster risk management

Finance

 

 

Expenditure 2019: 

  • Total expenditure in the year 2019 was USD 798,863.
  • The average of budget execution for health projects was 98% and for Citizen’s Charter 30%.
  • The reason for underspent was slow expansion of the activities in the insecure villages.
  • The administration cost was 9%. 

In-kind donations: summarized as following:

  • WFP donated foodstuff for supplementary feeding program; cost about US$ 9300.
  • UNICEF donated foodstuff and equipment for nutrition; cost about US$ 19,800.

 

 

Budget/expenditure in 2019

 

N.

Project Name

Period

Partner

Donor

Budget of the projects for 2019

Expenditure 2019 (US$)

Status

1

Health and Nutrition for drought affected people in Uruzgan Province

Jan-Jun

2019

UNOCHA, AHF

375,999

360,281

Completed

2

Targeted Supplementary Feeding Program (TSFP)

Jan-Jun

2019

WFP

26,957

26,957

Completed

3

The Strengthening and Scaling-up Malaria Prevention and Case Management to improve Health Status in Uruzgan

Jan-Mar 2019

UNDP,

TGF (malaria grant)

7,751

7,672

Completed

4

Citizen Charter Afghanistan Project (CCAP)

May 17-May 2020

MRRD,

WB

824,902

245,734

Continues

5

Lobby and Advocacy for Health Trajectory

Aug-Dec 2019

Cordaid

51,516

51,041

Continues

 Audit Report link

 

 
 

News & Events

Afghan Calendar 1400 (2021-22)

 

Healthcare in war zone. https://www.cordaid.org/en/news/cordaid-in-uruzgan-promoting-health-care-in-a-war-zone/    

N-Peace recognized, Mrs. Zarqa Yaftali, AHDS' Board Member, as Award 2019 winner for the on-the-ground action and powerful stories of peace-builders in Afghanistan. http://n-peace.net/winner-2019/ 

AHDS has been certified by ISO 9001:2015 as NGO working in health and social works. Certificate 1911QMS02

AHDS received the AICS Certificate and Award of Best Practice during the Stakeholders’ Coordination for CSOs Empowerment and Certified CSOs Award Ceremony on 31 Mar 2019 in Kabul Serena Hotel. Click here for details. 

AHDS received appreciation letters from the Local Government Authorities. Click here for details 

The Afghan Minister received the Best Minister Award in WGS 2019Click here for details. 

AHDS developed its five years Strategic Plan (2019-2023), Click here for details. 

Security incidents have directly harmed NGOs. We call upon  all  parties  to  the  Afghan  conflict  to  end  all  forms  of  violence  against Humanitarian Actors – including NGOs and their employees  click here 

AHDS received awards of best education programs from MoPH and AMNEAB in Kandahar and Urozgan provinces. Click here for details

Afghanistan's Ministry of Economics recognizes Afghan Health and Development Services (AHDS).   Click here to view certificate of recognition.

IRS form 990 click here

 

 

 

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