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.

Humanitarian Aid

AHDS provided emergency healthcare and psychosocial support for the needy people. The aim was to improve the wellbeing of the general population through improved access to primary healthcare (PHC) services targeting IDPs, returnees, and vulnerable host communities for one year in Uruzgan Province. Project was funded by OCHA from the Afghanistan Humanitarian Fund (AHF).

The services were provided by eight Mobile Health Teams (MHT) in remote conflict areas of Chenarto, Chorah, Khas-Uruzgan, Dehrawud and Shahid Hassas districts; Uruzgan Province.

The project ensured vulnerable people affected by conflict, natural disaster and population movement in districts are reached with quality, essential and life-saving healthcare services, including maternal and child health, reproductive health, mental health and psychosocial support, trauma care, health services for the elderly and rehabilitation for people with disabilities.

The project focused on the population pockets who do not have access to integrated package of essential health services (IPEHS). The health committees appreciated the assistance and asked for continuation of the health and related services.

Healthcare

Through the “Healthcare for drought and conflict affected people in Uruzgan” project, AHDS provided life-saving primary health care and psychosocial protection services for an estimated 35,081 host and internally displaced people in the target communities.

Eight Mobile Health Teams (MHTs) served communities in the remote areas of the selected districts. The team were based at the main villages and visited different locations, for provision of services on daily basis as per preannounced schedule in specified target areas of the districts.

During the project life (one year) the teams treated 101,280 patients including 30,432 men; 41,467 women; 14,326 boys and 15,055 girls. Out of the 976 patients including 656 acute malnutrition, 230 trauma, 23 mental health and 67 other severe cases were referred to the upper-level health facilities.

Focused psychosocial care and counseling was provided for 7739 patients and clients including 2,305 men; 2,977 women; 1,112 boys and 1,345 girls.

Health committees and community elders (1,118 people) were mobilized through community dialogue to prevent and response to GBV.

Furthermore, 4,563 trauma cases were treated; 1,396 antenatal care visits for pregnant women; 1,780 children received routine childhood vaccines; and 5,091 women, men, girls and boys received clinical management of mental, neurological or substance use disorders.

Polio

2021 has been the year of lowest polio transmission in Afghanistan. The factors that have been identified as contributing to continued polio transmission are: poor health service, lack of awareness, illiteracy, high incidence of diarrheal diseases, and low oral polio vaccine coverage.

Four wild poliovirus cases have been reported in 2021 in Afghanistan. The first case was reported in January 2021 from Ghazni Province, while the other three cases were reported in October and November from Kunduz Province.

The Polio campaigns are implemented by frontline workers who go door-to-door and health facilities to ensure every child is protected against the paralyzing disease. Communication and community engagement activities play a crucial role in encouraging and influencing behavior change amongst communities nationwide.

Polio vaccination campaigns in the last quarter 2021, reached children in areas previously inaccessible by the polio program including 2.4 million children who were vaccinated for the first time in over three years.

Six more campaigns are planned for 2022 and we must ensure they are implemented timely and reach all children. This remains the best opportunity to interrupt transmission of wild poliovirus and achieve eradication.

Source: UNICEF

Community Development

AHDS in partnership with SDO was 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 was a three-year project (May 2017 – May 2020), later on extended up to 31 October 2021.

The project management unit (PMU) under provincial rural rehabilitation and development directorate (PRRD) was responsible to transfer funds and assist the community development councils (CDC) to implement their community development plans (CDP).

The activities of this year were assisting the people in Cluster CDCs development plans, establishing CCDC subcommittees, trainings for the subcommittees, nutrition trainings, linkage meetings, community monitoring, score card, and distribution of aid to SIG beneficiaries.

As a result, the target communities gained the knowledge and skills to elect their representatives, assign tasks, community mapping, set priorities, develop plans, assist destitute, actively engage in emergency mitigation and development and finally manage their villages.

Impediment

The expansion of program was very slow, due to cultural restrictions on women and major number of villages under control of Taleban in Uruzgan Province. 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 the program, higher authorities promised full support, unfortunately, their field staff did not allow expansion in practice. AHDS Board Members and the community elders continuously strived to facilitate the ground works, in spite of several promises, it could not materialize.

The question of withdrawal was discussed with the Board Members, their advice was let’s keep trials; as Taleban authorities has not refused the program, there is hope to progress. Withdrawal will jeopardise the communities, not the conflicting forces.

The take over by Taleban could facilitate progress of the works in the field, but unfortunately, World Bank suspended all its operations in Afghanistan.

Since the contract is result based (US$ 5644.21 completed work in each community), the project has incurred an extra expenditure comparing to the funds received from the donor. AHDS has suffered a net loss of US$ 256,801, which is paid from its reserves.

Human Resource

AHDS provided 142 job opportunities in 2021; out of which 12% employees were women. 14 female and 22 male staff received in-service trainings including gender mainstreaming, monitoring, safe quitting, self-care for social change, accountability to affected people (AAP),

feedback and response mechanism (FRM), safeguarding, data management, mental health and psychosocial support (MHPSS), online data management (KOBO, ODK and Report Hub). Furthermore, 5 youth were enrolled as interns to learn hands-on finance and administration skills.

Future plan

Afghans in general, and the non-for-profit and civil society organizations in particular, are faced with a fundamental question; where should we focus our limited resources to maximize our effectiveness in the improvement of the socio-economic, social justice, and security challenges of the country.

AHDS’ theory of change describes how to ensure universal health coverage and the right to the highest attainable level of health. It can be achieved through promotion of healthy lifestyle, provision of primary healthcare and addressing the root causes of environmental and social threats to health. AHDS’ theory of change stresses the need to improve its ability to identify and respond to such moments. AHDS play its role by advocacy, technical assistance, and provision of development and emergency relief programs. AHDS can convene like-minded organizations such as civil society organizations (CSO), private sector, government and the international community.

AHDS advances diversity, equity, and inclusion throughout its internal culture and programs. AHDS focuses on the people with special needs, internally displaced people (IDP), returnees and other marginalized and disadvantaged groups especially those with disabilities. AHDS recognizes the importance of gender equality; therefore, is committed to mainstreaming gender measures.

AHDS’ strategic objectives are:

1. Healthcare: increased access focusing on emergency services, health promotion and prevention.
2. Nutrition: improved nutrition status of the children and pregnant and lactating women.
3. Education: empowered youths for provision of equitable services and economic growth.
4. Environment: protected human health and the environment.
5. Community development: enabled people to interact and work toward common goals.

The empowerment of our people is the fundamental path to achieving these dreams and aspirations. Social justice is only possible through quality education, promotion o sustainable livelihood, and good governance.  Therefore, it is our determination that we as a team at AHDS, along with our beneficiaries and partners, will strive tirelessly and patiently to do our part as part of the Afghan nation to overcome these challenges.

Finance

Total expenditure in the year 2021 was USD 864,677.

Due to the change of government on August 15, 2021, the banking system of Afghanistan has almost collapsed. Freezing of Afghan central bank’s assets by USA, freezing of bank accounts linked to the names of previous government employees, restrictions on transfer and cash withdrawal, and internal management challenges of the banks sent financial shockwaves in the country and halted the work of non-governmental organizations as well.

Despite all these challenges AHDS succeeded in good financial management and cash management through banks and Sarafs; could clear all its payable debts and claims as well as providing on time cash for project activities, staff salaries and suppliers dues.