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


Lobby and Advocacy for Health Trajectory

The objective 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 taxes (sin-tax: tobacco, vehicle, fuel, sugary-sweetened beverages “SSB”) for health, 3) Collection of user fees at hospitals and 4) Introduction of health insurance. The project is funded by Cordaid.

 meeting with MoPH health economy and financing department

Investment on the Health of People

Challenges:

Afghanistan is extremely poor and highly dependent on foreign aid. Much of the population continues to suffer from shortages of housing, clean water, electricity, healthcare and jobs. About 25% of its population is unemployed and 54% lives below the poverty line.[1]

In 2016, globally, the average per capita health expenditure was US$ 1,000; whereas the top 10 countries spent US$ 5,000 or more per person but half of the world’s countries spent less than US$ 350 per person. Globally, public spending on health per capita from domestic sources increased; in high income countries US$ 2,257, in lower-middle income countries US$ 58, in low income countries US$ 9 on average.[2] In Afghanistan, input from domestic sources is only US$ 3.4 while the average total health expenditure per capita is about US$ 71.    

Afghanistan’s health system is heavily financed by international donors and private household expenditure. Approximately 72% of total health expenditure (THE) was paid by households’ out of pocket (OOP), about 23% by international partners and only 5% by the government of Afghanistan.[3] The high OOP expenditure has resulted in a substantial financial burden on households. According to the national budget decree 1398 (2019), the government allocated only 4.2% to the health sector.[4] The share of the government allocation to the health sector is far lower than the target of 15% recommended by the Abuja Declaration.

Public health interventions are often opposed by powerful commercial interests, and the health gains for individuals are often perceived as too small to sway their voting intentions, despite adding up to large gains at the population level. Actually, the public health interventions are cost-saving and offer substantial returns on investment (ROI). The ROI for all public health interventions is 14.3 implying a cash return of more than 14 fold.[5]

 meeting with Haji Qudrat Parliament member

Solutions:[6]

Therefore, we need to increase domestic revenue for health to reduce the dependency on external aid, reduce the reliance on out-of-pocket spending and increase government contributions to the health sector in Afghanistan. The strategies for increasing domestic investment in health is organized around four key areas:

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 health insurance; protect from catastrophic health expenditures.

Why sin-taxes*:

1.    Smoking is one of the major risk factors for cardiovascular diseases, lung diseases and cancers.

2.     WHO-2017: reported 5,461 deaths and 25,654 sustained injuries due to road accidents annually in Afghanistan.

3.    Air pollution due to emission of hazardous gases of vehicles is a raising health concern in Afghanistan.  Studies show that pollution emitted from fuel has an adverse effect on health; cardiovascular, respiratory and cancers.

4.    The sugary beverages are accountable for about 183,000 deaths worldwide each year; this includes diabetes, heart disease and cancer deaths.

 orientation for midwives

For what: increased revenue enables MoPH to focus on 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.

 orientation for, Ms Gulalay Mohammadi, a parliment member who actively advocates for the issue

Expectations:

1.       Increased government budget allocation on health.

2.       Excise tax earmarking for health.

3.       Obligatory health insurance.



[1] World Bank, website.

[2] Public Spending on Health, A Closer Look at Global Trends, WHO, 2018.

[3] MoPH, The National Health Accounts (NHA) report 2014.

[4] National Budget, 1398, consolidated by ministries.

[5] BMJ, Return on investment of public health interventions: a systematic review, Volume 71, Issue 8.

[6] The MoPH Revenue Generation Strategic Framework, 2018. 

News & Events

Calendar 1398 (2019-20)

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 

Dr. Ferozuddin Feroz, Minister of Public Health of Afghanistan 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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