Improve access of the Vulnerable Population to Essential Primary and Secondary Health Services Including Inpatient Management of Complicated SAM Afghanistan is experiencing an extensive and complex humanitarian crisis characterized by violent conflict, large-scale displacement, a pandemic that continues to spread, and a major drought. At the start of 2021, there were 18.4 million people in need of humanitarian assistance — the 4th largest humanitarian caseload globally. Initial figures indicate that this number will go up to 22 million in 2022. The ongoing escalation of humanitarian need is being complicated by the political events of August 15th and the resulting pause of long-term development funding by international donors to the “Sehatmandi” project delivering basic and essential packages of health services (BPHS and EPHS) across the country. Being the backbone of the Afghan health system, its cessation of services by September 11th had a devastating impact on health care delivery all over the country. 

Since August 15th the country wide security situation has stabilized and all 34 provinces are accessible to receive support through humanitarian assistance. This includes all white and underserved areas which now call for a large scale up of humanitarian assistance to support the delivery of primary health care services. At the same time mass causality incidents have been a regular occurrence and as a result, the demand for trauma care has increased, in 2021 alone it was estimated for some 310.500 people to require emergency trauma care. Its provision is almost exclusively delivered by humanitarian partners in Afghanistan, despite the high prevalence of mass casualty incidents, basic and essential surgical care remains outside of the seven major elements of the Basic Package of Health Services (BPHS). Preparedness for and capacity to respond to trauma incidents to avoid possible mortalities and morbidities by enhancing the trauma care services at the hospital and pre-hospital levels has remained a high priority. WHO is supporting 130 hospitals in emergency care, along with the provision of supplies and equipment, organization and planning, blood bank support, HR capacity building, mass casualty management, disability and physical rehabilitation and mental health support.

The action presented in this project proposal aims to preserve the essential health service delivery in priority areas of Afghanistan through the provision of emergency and trauma medical kits to Health Facilities (HF) in areas with highest needs as they align with the AHF allocation strategy. Emergency medical kits will be delivered to HFs in Badghis, Helmand, Ghor, Samangan, Balkh, Uruzgar, Farah, Kunduz and Zabul provinces. Supplying HFs with essential medicines and materials and equipment to deliver primary health care services is in line with activity 1 of the strategic allocation. WHO will also deliver trauma care kits to HFs in Parwan, Kabul, Ghazni, Kandarhar, Herat and Kapisa provinces. These kits include essential medicines and equipment for trauma cases management. This activity is in line with activity 4 of the strategic allocation. In this presented action WHO will also support secondary care hospital through the recruitment of implementing partners to deliver primary and secondary healthcare services including trauma. Through the implementing partners general operating expenses, staff salaries and medical supplies will be supported in Ata Turk Hospitals in Kabul province. WHO is aligning with activity 1 and 4 of the allocation strategy. WHO will also support the in-patient management of complicated SAM cases with this action in order to fill the gaps within the existing essential health service delivery. WHO will support 44 therapeutic feeding units that SAM cases with complications are referred to by delivering medical and non-medical equipment and supplies. The centers are strategically located in 13 provinces all over the country in line with the nutrition part of the strategic allocation linking to theme 1 activity 1 and 4.