Improving Environmental Health Measures in Health Care Facilities of High Needs in Afghanistan Afghanistan has been facing complex crises in the past and has recently seen a severe deterioration of the situation since May 2021. The recent events have generated more than 600,000 internally displaced persons (IDPs) and exacerbated disease outbreaks. Afghanistan is currently facing a complex confluence of crises including residual conflict and associated high levels of population displacement severe drought, food insecurity and malnutrition (up to 50% of children at risk of acute malnutrition) the COVID-19 pandemic outbreaks of other infectious diseases (e.g. measles, acute watery diarrhea, dengue) risk of upsurgence of polio cases and major economic decline. Out of a population of approximately 40 million persons, there are 18.4 million people (46% of the total population) in need as of January 2021, with over 500,000 persons displaced. It is estimated that there will be approximately 24 million persons in need by January 2022 a 30% increase from 2021. The Taliban have not been recognized by the international community and international funding has been put on hold for most programs, exacerbating existing fragility and increasing the economic downturn. The current situation presents substantial operational constraints to the UN’s efforts to maintain existing programs and to scale up the response to increasing humanitarian needs. The Afghan economy and the health sector have been mostly dependent on external financial support and development funding for years. Destruction of the health facilities' infrastructures due to recent conflicts coupled with lacking funding for reconstruction have resulted in poor physical condition of the health facilities including the environmental health measures. The proportion of Afghans who can access safe drinking water and sanitation are one of the lowest in the world, Water Hygiene and Sanitation (WASH) at the health facility level is no exception, 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 (HNO 2021), as a result, inadequate WASH services continue to be a major issue in Afghanistan which threaten the quality and safety of healthcare. An assessment was conducted by WHO though its sub-offices in West, South, South-East and East Regions. For better data collection, a WASH assessment checklist was developed and shared with Sub-Offices, relevant PHDs and target health facilities authorities both in hard and soft copies. Filled checklist were returned to the Sub-Offices and WASH needs shared with the WHO-Country office. More than one hundred health facilities were assessed and 69 health facilities were selected for this WASH intervention. 
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 on WHO assessment and in accordance with the allocation strategy and WASH cluster priorities, through this grant, WHO will support WASH facilities in 69 priority health facilities (6 DHs, 40 CHCs, and 23 BHCs) located in Badghis, Ghor, Hirat, Hilmand, Uruzgan, Zabul, Kandahar, Paktika, Paktiya, Nangarhar and Laghman 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 and national NGOs. Through this AHF Standard Allocation Fund, WHO will provide sustainable WASH services in 16 vulnerable provinces for approximately 86,700 people.