AHDS Annual Report 2025 (click to download PDF version)

Annual Report 2025

 

Foreword

In 2025, Afghanistan’s health sector has made further strides despite enduring challenges, demonstrating resilience and adaptation amid a complex socio-political landscape. Enhanced coordination with international partners has facilitated the expansion of healthcare infrastructure, including the establishment of more fully equipped clinics and training for local health workers.

Maternal and child health indicators continue to improve, with increased access to skilled birth attendants, expanded immunization coverage, and community-led nutrition programs contributing to declines in maternal and under-five mortality rates.

Progress in mental health services has gained momentum through the integration of psychosocial support within primary healthcare, helping to address the widespread trauma caused by decades of conflict.

Efforts to control infectious diseases like polio and tuberculosis are showing positive results, supported by innovative outreach strategies that combat misinformation and resistance.

Additionally, a focus on enhancing the quality of care has led to improved health outcomes, with ongoing training and accreditation initiatives ensuring that patients receive safe, respectful, and effective services.

While significant hurdles remain, such as ensuring equitable healthcare access across all regions and strengthening health system resilience, the ongoing progress requires commitment to building a healthier future through sustained investment, community engagement, and strategic partnerships.

 

Results in 2025
Population Covered OPD Consultation Health Education Mental Health Tuberculosis Treated
1,335,881 2,142,626 1,762,376 42,109 367
Antenatal Care Visists Institutional Deliveries Cesarean-Sections Postnatal Care Visits Tetanus Vaccine for Women
83,376 35,437 496 52,443 84,937
Birth Spacing Under 5 Morbidities Vaccinated under 1 Child Growth Monitoring & Child Feeding Severe Malnutrition Treated
10,731 481,146 37,034 89,962 17,962
Hospitalized Patients Major Surgeries Minor Surgeries Physio-therapy Referral by Ambulance
20,274 1,697 18,716 7,132 6,147
Jobs created Health Facilities Training Participants Supervisions Grievance Redressed
1,957 169 1,291 910 188

Projects in 2025
 

Health Emergency Response (HER) in Uruzgan

The basic package of health services (BPHS) and essential package of hospital services (EPHS) through 64 health facilities for 589,762 people in the entire Uruzgan Province. The project was part of UNICEF’s HER program (Jan 2024-Jun 2025) funded by Asian Development Bank (ADB).

A new contract is signed under the title “strengthening access to essential food security and health services (support for Afghan people) project; SAFE Projects”, extending the services from 1 Jul 2025 till 31 Dec 2026.

Live saving PHC in White-areas

This is “provision of primary health care services” through 15 health facilities for in Helmand, Nimroz, Urozgan and Zabul provinces. The project is funded by WHO to serve 100,909 direct beneficiaries form 1st Oct 2024 to 15 Jul 2025.

Life-saving Reproductive Healthcare

That is to “increase access to basic reproductive maternal, newborn, child and adolescent health (RMNCAH), immunization, and nutrition services” through 85 FHHs in Helmand, Kandahar, Nimroz, and Urozgan provinces. The project is funded by UNFPA that serves 313,874 direct beneficiaries.

Humanitarian Care

The project is “Integrated primary healthcare services in Kandahar and Helmand” through 5 basic health centers (BHC) for 52,765 people in prioritized districts. The project is funded by OCHA (22-May-2025 to 21-May-2026) as part of Afghanistan Humanitarian Fund (AHF).

Infectious Diseases

The “combined grant to support HIV/AIDS, Tuberculosis & Malaria programs and Health Systems in Afghanistan” is funded by GFATM. AHDS implements tuberculosis and malaria control as a sub-recipient of UNDP in Uruzgan Province. This is integrated to the HER project mentioned above.

Accurate Diagnosis, Better Care
Haq Dad, the son of Asadullah from Marja district in Helmand province, sought medical care at Khod Sub-Health Center (SHC) in Charchino district, Urozgan. He initially presented with unknown fever and body pain that was diagnosed typhoid fever in a private clinic. Despite undergoing multiple treatments, his condition did not improve. Recognizing the need for further assessment, the in-charge health worker at Khod SHC conducted a Rapid Diagnostic Test (RDT), which confirmed a positive result for Plasmodium vivax (Malaria PV). Based on this accurate diagnosis, Haq Dad was prescribed Chloroquine and Primaquine tablets. His contact information was recorded to facilitate proper follow-up. A few days later, the health team reached out to him, and he reported significant improvement and expressed satisfaction with the care he received. This case underscores the importance of precise diagnosis and diligent follow-up in public health settings. Unlike many private practitioners who often overlook patients’ medical history and prescribe unnecessary medications without proper assessment, Khod SHC exemplified a patient-centered approach that led to effective treatment and recovery. This success story highlights the critical role of quality diagnosis and comprehensive care in achieving better health outcomes and reducing unnecessary healthcare expenses.

Infectious Disease

Urozgan province faces a high risk of tuberculosis (TB), but it has a low risk for malaria and leishmaniasis. The health initiative is integrated into the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS), ensuring comprehensive health coverage. Health facility staff and health post workers received specialized training, along with necessary equipment and medicines, to effectively manage these diseases.

This integrated approach has improved the capacity of local health facilities to accurately diagnose, treat, and control TB and other communicable diseases, thereby strengthening disease management at the community level and addressing public health priorities in Urozgan.

Control of tuberculosis, malaria and leishmania in Urozgan is a part of the “Combined grant to support HIV/AIDS, Tuberculosis & Malaria programs and Health Systems in Afghanistan” project. This is led by UNDP as principal recipients from The Global fund to fight AIDS, Tuberculosis and Malaria (GFATM).

The program targets the general population as well as vulnerable groups such as residents in remote areas, women, children, prisoners, migrants, and people living with HIV.

Saving Life

At Terinkot Provincial Hospital, the Obstetrics and Gynecology department proudly shares a remarkable success story that highlights the critical importance of swift, coordinated emergency care in saving maternal lives.

Mrs. Malika, a 32-year-old woman at approximately 28-30 weeks of pregnancy, was urgently referred from Dehrawud District Hospital in a life-threatening condition due to severe vaginal bleeding caused by placenta previa, compounded by hemorrhagic shock. Upon her arrival, the dedicated medical team immediately mobilized to stabilize her—establishing large-bore IV lines, administering oxygen, IV fluids, and blood transfusions, along with medications to control bleeding and support vital functions. Despite her rare blood group and the limited availability of compatible blood, the team quickly arranged for a blood transfusion from the hospital’s blood bank. After initial stabilization, she was swiftly prepared for emergency cesarean section under general anesthesia, which was successfully performed without intraoperative complications. Postoperatively, Mrs. Malika was monitored closely in the recovery room, and her condition gradually improved.

This case underscores the importance of rapid referral systems, timely decision-making, effective teamwork, and resourcefulness in emergency obstetric care. The successful outcome in this high-risk situation demonstrates the hospital’s commitment to maternal health and highlights the critical need for preparedness and coordinated response in saving lives during obstetric emergencies.

Healthcare; Urozgan

In 2025, the health emergency response project in Uruzgan Province focused on consolidating and expanding existing healthcare services, ensuring sustainable improvements in the delivery of essential health care. Major efforts were directed toward strengthening the capacity of health facilities through training and capacity-building initiatives, enhancing service quality across the network. The project continued to support the operationalization of the orthopedic department at the provincial hospital and maintained the functionality of mobile health teams and community health posts, which remain crucial in reaching nomadic populations and remote villages. Additionally, ongoing renovations and minor upgrades ensured that health centers and hospitals maintained a conducive environment for patient care. The project’s efforts in community engagement and health promotion contributed to increased utilization of services and improved health awareness among the population. Overall, 2025 marked a year of stability and incremental progress toward better health outcomes in Uruzgan Province.

AHDS provides Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) through 64 health facilities in Uruzgan Province. The project serves over 589,762 residents in 7 districts and 508 villages. This network includes a provincial hospital, district hospitals, CHC-Plus, comprehensive and basic health centers, BHC-Plus, sub-health centers, as well as specialized clinics like prison health and mobile health teams for nomadic populations, supported by 469 community health posts to ensure broad healthcare coverage.

A Tale of Hope
Shahina, a 25-year-old mother from Arghandab District in Kandahar Province, experienced the heartbreaking loss of her four-year-old son to measles three years ago. At that time, she had limited awareness of the importance of vaccination, and her family strongly opposed immunization. Later, Shahina visited Sikh-Chala Basic Health Center (BHC), supported by AHDS (funded by OCHA from AHF). During her visit, she received vital health education about the significance of routine immunization and how vaccines can prevent deadly diseases. Reflecting on her past tragedy, Shahina expressed deep regret and recognized that timely vaccination could have saved her child’s life. Despite her increased understanding, she faced resistance from her family regarding vaccinating her children. To address this, health workers engaged a respected family elder, providing culturally appropriate information about the benefits of immunization and child health. This dialogue helped build trust, and with family approval, Shahina’s six-month-old child was successfully vaccinated. She now regularly brings her children for scheduled immunizations and has become an active advocate for immunization within her family. Her efforts have encouraged several other children in her extended family to receive their vaccinations as well.

Humanitarian Care
AHDS expanded humanitarian assistance in underserved areas with high health needs, by providing access to primary healthcare services. Five new basic health centers (BHC) were established the areas currently lacking adequate health services in Helmand and Kandahar. Core activities include provision of essential medicines and medical supplies, and training healthcare workers to deliver a broad range of services. These services encompass reproductive health, maternal, newborn, and child health, as well as nutrition support for children under five, pregnant, and lactating women. The project also provides immunizations for children under two and women of childbearing age, and establishes referral linkages with upper health facilities for complex cases. It emphasizes mental health and psychosocial support (MHPSS), infectious disease prevention and outbreak response, and management of both communicable and non-communicable diseases. Special attention is given to persons with disabilities through referrals and provision of simple assistive devices. Additionally, the project incorporates Risk Communication and Community Engagement (RCCE) activities to enhance preparedness and response during disease outbreaks and natural disasters like floods. It promotes effective communication, information sharing, and coordination to improve healthcare delivery for vulnerable populations, ensuring women-friendly service provisions.

White-areas

The project is designed to significantly improve healthcare access and quality in the underserved regions of Nimroz, Hilmand, Zabul, and Urozgan provinces. It aims to enhance access to essential healthcare services, focusing on equitable and uninterrupted primary healthcare, nutrition, and psychosocial support.

The services are delivery of comprehensive primary healthcare, including maternal and newborn health, child immunization, nutrition, mental health, and psychosocial support, while establishing efficient referral systems for patients requiring secondary or specialized care. Key activities include deploying trained healthcare staff through targeted capacity-building initiatives, promoting awareness of key health and nutrition messages within communities, conducting regular nutrition screenings for children under five and pregnant or lactating women, and facilitating early detection and management of non-communicable diseases like diabetes and hypertension through screening and counseling. The project emphasizes a holistic approach, with a focus on increasing coverage, improving health outcomes, and ensuring sustainability of services in these remote areas. The project successfully met its intended target.

Transformative Impact
Mrs. Raziya’s journey from fear and trauma to hope and safety exemplifies the transformative impact of community-based maternal health interventions. Prior to the establishment of the Garmab Family Health House (FHH), she had experienced four home deliveries, two of which resulted in neonatal loss, leaving her with profound emotional distress and a perception of pregnancy as a life-threatening ordeal. Limited access to skilled birth attendants, poor infrastructure, and entrenched traditional practices compounded her vulnerability. However, through persistent outreach by Community Health Workers and the Family Health Action Group, Mrs. Raziya received education about the importance of skilled care and the services now available at the FHH. This gradually built her confidence and trust in formal health services. When she became pregnant again, she actively sought antenatal care and was welcomed by trained midwives, who provided comprehensive assessments and health education. During her labor in December 2025, she delivered her baby in a clean, controlled environment under the supervision of professional midwives, who promptly managed a minor complication involving postpartum bleeding. The safe delivery and attentive postnatal care not only ensured her and her baby’s health but also marked a significant emotional turning point. For the first time, Mrs. Raziya experienced childbirth as a dignified, safe, and respectful process, alleviating her long-standing fears and emotional trauma.

Family Health House

Access to healthcare in Afghanistan remains a significant challenge due to difficult geography and conservative cultural norms. Remote populations in vast deserts and mountainous regions often lack proper road connectivity, making it difficult to reach healthcare facilities. Even when women do access health services, privacy concerns pose a major barrier; many women feel uncomfortable delivering in facilities where male staff or visitors are present, fearing shame or social stigma. Labor pains are intense, and the presence of unfamiliar men can discourage women from seeking care. Additionally, discussing reproductive health or family planning openly is often taboo, especially if men might overhear conversations or if male pharmacists dispense contraceptives.

The Family Health House (FHH) model offers an effective solution by providing community-based reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services through trained community midwives. These FHHs increase access for women and adolescent girls, particularly in underserved white areas, by bringing healthcare closer to their neighborhoods. The model also enhances female healthcare workforce availability and includes in-service training and supervision to improve service quality.

The initiative aims to expand access to essential RMNCAH services in 85 prioritized white areas across Helmand, Kandahar, Nimroz and Uruzgan provinces.

The FHH approach comprises four key components: the FHH itself, health posts operated by male and female community health workers (CHWs), two family health action groups (FHAG), and a community health committee (Shura). In Helmand and Kandahar, nutrition and vaccination services are also integrated into the FHH model.

Polio in Afghanistan

The ongoing polio situation in Afghanistan remains a significant public health concern, with 9 confirmed cases in 2025 across multiple provinces, reflecting a decline from 25 cases in 2024 but still indicating persistent circulation of the wild poliovirus. The cases were detected from Uruzgan, Helmand, Badghis, Nuristan, Paktika and Farah.

Despite continuous vaccination campaigns targeting children under five, challenges such as logistical issues and misinformation continue to impede eradication efforts. These obstacles underscore the importance of sustained vaccination initiatives and community engagement to eliminate polio completely from Afghanistan, which remains one of the last endemic areas, posing a threat to global eradication goals.

 

 Human Resource

  
In 2025, AHDS provided a total of 1,957 employment opportunities, with women representing 38% of the workforce. The organization emphasized continuous professional development by encouraging nearly all employees to participate in a diverse array of short-term training courses throughout the year. These courses covered various aspects of health services and management, fostering comprehensive skill enhancement. AHDS enhanced staff knowledge and skills across various domains by organizing 131 short training programs, benefiting a total of 1,770 participants, including 1,133 men and 637 women. Of these, 103 courses were conducted in collaboration with partner organizations and other entities. Additionally, AHDS trainers successfully delivered 28 specialized training sessions focused on deepening their understanding of primary healthcare components and services.
These training initiatives were designed to equip healthcare workers with the essential skills needed to improve service delivery and meet community health needs effectively. Supervisors play a vital role in supporting staff by ensuring that the knowledge and skills acquired through these training programs are effectively implemented in both administrative and clinical settings. This hands-on approach not only reinforces learning but also promotes a culture of accountability and ongoing professional development, ultimately contributing to the enhancement of healthcare quality and service excellence.

 

Finance

  
In 2025, the total budget was USD 10,866,425, with an expenditure of USD 10,146,051, reflecting 98% budget execution rate. The primary challenge encountered was the delayed signing of agreements and the transfer of funds from certain donors to our bank accounts. Despite these obstacles, AHDS successfully maintained sound financial and cash management practices through banking institutions. This enabled the organization to settle all payable taxes and debts promptly, as well as to ensure timely disbursement of cash for project activities, staff salaries, supplier payments, and operational expenses.