Community-based comprehensive Mental Health & Psychosocial Support and Physiotherapy services to at-risk, hard-to-reach and vulnerable populations Afghanistan faces a dire economic situation, a country ravaged by four decades of war. Since the regime change in 2021, the nation has entered a period of economic collapse that it is still struggling to overcome. Afghanistan has an estimated population of 43 million, with 51% males and 49% females. Nearly 47% of the population is under 20 years old. The country's population is projected to grow at a steep annual rate of 2.3%. However, the Humanitarian Needs report for 2023 reveals a challenging picture: 28.3 million people, which is 66% of the total population, require urgent humanitarian assistance due to the second year of economic decline, drought, and political deadlock.
The Integrated Food Security phase Classification (IPC) assessment from May to November 2022 shows that 19.7 million people, which is 47% of the analyzed population, are in IPC Phase 3+ (Crisis). In Ghor province, there are 20,324 individuals in IPC Phase 5 (Catastrophe), facing the risk of starvation. Furthermore, 6.6 million people (16%) are in IPC Phase 4 (Emergency), at risk of severe malnutrition and excess deaths, while 13 million (31%) fall into IPC Phase 3 (Crisis) due to food consumption gaps. The Afghanistan Humanitarian Needs Overview 2023 reveals that 24.4 million people, including 22% women, 54% children, and 8.3% persons with disabilities, require humanitarian assistance.
In this challenging context, there is an urgent need for Mental Health and Psychosocial Support (MHPSS). Decades of conflict, recent political changes, international sanctions, frozen offshore assets, natural disasters, poverty, drought, and the ongoing COVID-19 pandemic have created a severe humanitarian and development crisis in Afghanistan. Women face limitations in public spaces and restricted access to institutions such as higher education. General Objective:
Building ‘spaces of peace, inclusivity and support for healing and cohesion’ in 120 communities of four (4) provinces in Afghanistan where 50000 people, particularly the most vulnerable suffering from mental and/or physical trauma, have access to trauma healing and psychosocial support, becoming empowered to contribute towards safe, just and inclusive communities.
Specific objectives:
SO 1. Access at community level for MHPSS counselling for persons and groups in all diversity exposed to prolonged trauma and suffering.   
Specific outcome to objective 1: Establishing community MHPSS with a network of trained community based MHPSS counsellors and community resilience centers, inclusive of marginalized populations with a special focus on survivors of GBV, youth and persons with a disability (PWDs). 

SO 2. Improve availability of contextualized, adequate MHPSS by integrating these services in a sustainable manner into the existing health system at different levels, increasing access and availability at community, clinic and rehabilitation levels.
Specific outcome to objective 2: Comprehensive Rehabilitation units at provincial hospitals are strengthened with both training and support to professionals for severe mental health and physical disability conditions and community based MHPSS counsellors and improved referral lines to other service providers. For severe cases. . 	

SO 3. Community participation by members of all genders, ages and diversity, peacebuilding, social inclusion and community cohesion enhanced.
Specific outcome to objective 3: Local authorities, social and religious leaders-, youth-, women- and PWD- leaders are engaged to sustain inclusive community dialogues and peacebuilding activities. These activities and opportunities for dialogue are established in 120 communities in 4 provinces and 12 districts. 

Given the challenges for this project, given the risks and given the desire of the EKN to show elements of impact and sustainability, we proposed to the EKN that we focus first on SO 1 and 2 (capacity building for MHPSS at community and hospital levels with a strengthened referral service) during the first phase of the project 2024-2025.  Gradually, we hope conditions will become such that the project can expand with more and more activities for objectives 3 (conflict resolution, prevention of SGBV, transfer of ownership of the project) in 2026 and 2027. Thus, outputs will be described in detail only for the first two years. Direct target group:
More than 80% of the population in the target areas will directly and indirectly benefit from the project including those who are suffering from mental distress and collective trauma, with a special focus on:
1.	Men and women who suffer from Mental Health conditions.
2.	Survivors of GBV or of child abuse
3.	Youth – Out-of-school girls and out of employment adolescent women and men
4.	Doctors and staff of community health posts, BHCs, CHCs/+ and District/provincial/regional hospitals (DH, PH, RH) 
5.	Persons with physical or mental disabilities. * 
*This last group includes people that have become physically handicapped during the conflicts and are likely to have mental distress; traumatized by the event that caused the disability.

Indirect target group:
1.	Religious leaders, community elders, schoolteachers
2.	Family members / carers of those suffering from mental health issues or physical disability
3.	suppliers and service providers
4.	 Government authorities
5.	Other NGOs.