Improving Environmental Health Measures in 105 Health Care Facilities of High Needs in Afghanistan Afghanistan is experiencing an extensive humanitarian crisis characterised by political and economic instability, a severely weakened health system, food insecurity and malnutrition, ongoing outbreaks, a pandemic that continues to spread, severe drought and different natural disasters. This is even more profound in areas with little to no health service – this area is often referred to as white or underserved areas. 

A deterioration of the health facility infrastructure due to long years of conflict, coupled with lacking funding for reconstruction and rehabilitation have resulted in the poor physical condition of health facilities including the environmental health measures. In 2021, out of the 8.8 million people in need of WASH assistance, almost 1.2 million could be related to WASH at health facility level, as a result, inadequate WASH services continue to be a major issue in Afghanistan which threaten the quality and safety of healthcare. Furthermore, to contribute to AWD outbreak response and ensure water availability, and sanitation and hygiene facilities at the health centers, WHO has conducted an assessment of the health facilities in West, South, North, Northeast and East regions. More than 200 health facilities were assessed and 120 health facilities in 11 provinces were identified as being in critical need of WASH facilities and environmental health measures to be considered under this project.

WHO as a normative agency for WASH at the facilities and as part of its global mandate is focusing on enhancing WASH, and medical waste management system in health facilities to ensure safe and hygienic environment in health facilities. Based WHO assessment, and in accordance with the allocation strategy and WASH cluster priorities through this grant, WHO will support WASH facilities and environmental health measures in 105 priority health facilities (12 DHs, 29 CHCs, 59 BHCs, 4 SHCs and 1 speciality hospital) located in Kandahar (Kandahar city, Shahwali Kot, Boldak, Miawand, Zery, Ghorak, Khakriz, Mianishen, Arghistan, Nish, Arghandad, and Panjwayee districts), Badghis (Qadis, Jowand, and Aab Kamari districts), Baghlan (DehSalah, Puli-Hesar, Dahana-e-Ghoori, Borka, Khowaja-Hejraan, Khenjan, Baghlan-e-Jadeed, and Khost-wa-Fereng districts), Farah (Anaar Darah, Farah city, Laash-o-Jaween, Por Chaman, and Sheeb Koh districts), Faryab (Sherin Tagab, Andkhoi, Dawlat Abad, Belcheragh, Kohistan, Pashtonkot, Maimana, Khanchrbagh, Qaramqul, and Qurghan districts), Ghor (Tolak, Pasaband, and Cheghcheran districts), Hilmand (Nawazad, Baghran, Khanasheen, Gramsir, Baghran, and Khan Nesheen districts), Hirat (Karokh, Sheendand, and Gulran districts), Jawzjan (Aqcha, Darzab, Faizabad, Mingaajik, Mordian, Qashtapa, and Sheberghan districts), Samangan (Daresuf Bala, Daresuf Payen, Ruy Doab, Aybak, and Ruy Doab districts) and Saripul (Balkhab, Kohistanat, Sancharak, Gosfandi, Kohistanat, Sarepul Center, and Sozmaqala districts) provinces. The health facilities will be supported through rehabilitation and boring of water wells and water supply piping networks, rehabilitation and construction of toilets, rehabilitation and construction of septic tanks, installation of hand wash basins, establishment of medical waste management facilities (ash pit, sharp pit etc.), installation of waste incinerators and procurement and supply of waste collection containers. WHO will implement and supervise the activities on the ground directly and will not sub-contract to any international or national NGO. Through this project, WHO will directly benefit 118,300 people referring to the target health facilities during the project time-frame, while the established facilities will remain for utilization after the project close out. This project will perform sanitation and hygiene interventions in all the target 105 health facilities, however, for water interventions only 104 health facilities will be considered (excluding Spinboldak DH).