nlp-thedeep/humsetbias huggingface dataset:
Further support is required to fully implement commitments to prevent the recruitment of children into armed conﬂict by the police and the army.
The United Nations Secretary General's  ( SG )  recent Report on Children Affected by Armed Conflict  ( CAAC )  covering 2019 identified Afghanistan as the deadliest country on the planet for children in conflict for the fifth consecutive year.
The Government of Afghanistan has signed an action plan that includes annexes related to sexual violence and attacks on schools and has developed a road map for its implementation that can end recruitment and use of children by its armed forces.
The 48 per cent increase in number of people in need came largely as a result of the inclusion of all people in crisis or emergency food insecurity  ( IPC 3 and 4 ) .
The increase in the Protection Cluster's need estimate from 11.5 million in mid 2020 to 12.8 million in 2021 reflects the ongoing risks presented by worsening conflict, compounded by additional challenges for vulnerable groups as a result of the economic and social impact of the pandemic.
Among those most affected are likely to be women and girls from families living in poverty, those living in remote, rural and/or conflict affected areas, internally displaced and returnee women and girls, and women and girls with disabilities. Many of these women and girls have limited opportunities to continue learning at home, so the closure of schools is likely to particularly affect their longer term healthy development.
Increases in the number of people in need of Emergency Shelter and Non Food Items  ( ES NFI ) , from 5.3 million in mid 2020 to 6.6 million in 2021; and WASH from 7.2 million in mid 2020 to 8.8 million in 2021, both reflect increased needs due to COVID 19 and the consequences in years of under investment in more sustainable solutions for displaced people.
It highlights the need for more inclusive and robust social protection measures that guarantee a set of essential social services and income security measures for women, men and children in Afghanistan.
If these social protection needs are not met in a timely manner, people risk falling into or into more severe humanitarian need, threatening hard fought development gains and requiring a more expensive emergency humanitarian response.
In addition, 56 per cent of people reported having less than three out of six essential household items. These household items are a necessity, not only as part of an emergency response, but also in mitigating the spread of COVID 19 and in reducing the number of households sharing core relief items.
Existing poverty and vulnerability to shocks due to insecure, unstable and inadequate earnings have been exacerbated by COVID lockdown and social distancing measures.
Over the past 5 years, the food security situation in Afghanistan has steadily deteriorated with the percentage of food insecure people doubling  ( from 37 per cent in September 2015 to 76 per cent in Nov 2020 ) , while the proportion of people in crisis or emergency levels of food insecurity has increased more than five fold  ( from 8 per cent to 42 per cent over the same period ) .
Hospitals and clinics are reporting challenges maintaining or expanding their facilities' capacity to treat patients with COVID 19, as well as maintaining essential health services, especially in areas of active conflict.
Furthermore, loss of wages and the decline in household income have eroded people's living standards in both rural and urban areas, leaving people in need in city locations where this has not been seen before.
2020 saw a surge in people returning to Afghanistan from Iran – an early hotspot for COVID 19. This accelerated community transmission of the virus across all 34 provinces as returnees fanned out across the country, back to their places of origin or into overcrowded urban centres.
As of mid December 2020, there were almost 50,000 confirmed COVID 19 cases in Afghanistan across all 34 provinces.
Pressure on living conditions continues to be exacerbated by displacement, including return of refugees from neighboring countries and conflict induced internal displacement.
An expected uptick in violence in the short term is likely to impact negatively on the safety environment for civilians, exposing them to ongoing threats of violence and reduced movement.
Overall, displaced households primarily chose host communities as their Area of Displacement  ( AOD ) , likely due to the presence of basic services, followed by family members in another area. In a limited number of cases, affected households displaced to informal settlements  ( Herat, Balkh, and Paktya provinces ) .
In cases of conflict or evacuations with the presence of armed actors, collective security elements were frequently reported to not allow affected households to take any personal items  ( NFIs )  with them, increasing hardship for IDPs during their displacement and after reaching their AOD.
Access constraints reduce reach and capacity of humanitarian actors to respond to the needs of conflict and displacement affected communities, with negative implications for meaningful and safe access to services for individuals and communities requiring assistance, including protection support.
In terms of protection, agencies reported reduced capacity to ensure safe referrals for persons requiring specialized services. Across all provinces, affected communities reported limited daily labor opportunities due to COVID 19 movement restrictions, particularly impacting on displacement  affected households reliant on wages from daily labor.
Based on available data, girls, women and the elderly are most likely to be negatively impacted due to these limitations.
While during the period COVID 19 and associated restrictions mandated limited general movements in public spaces, the majority of assessments observed that restrictions were not strictly adhered to across most groups, and therefore is unlikely to skew data significantly. The main exception to this would be elderly persons and those with chronic illnesses, who based on either vulnerability awareness or stigmatization were more likely to select or be forced to stay indoors.
During the period, the majority of displaced households resided in rented properties in their AOD, followed by temporary/makeshift structures, host community homes, unfinished structures, damaged structures, tents, and least commonly finished structures. Households residing in rental properties face additional risks of reduced savings, debt incurrence, and reliance on negative coping mechanisms to afford payments, along with risks of exploitation and eviction.
Additional assessment teams and resources to provide emergency shelter and handwashing facilities to IDPs staying in open spaces are urgently needed.
Households residing in temporary/makeshift structures, unfinished, damaged shelters or tents incur increased vulnerability to multiple threats, including exposure to the elements, assault, criminality, or sexual violence, highlighting the importance of shelter responses in reducing protection risks.
Moreover, IDPs residing in temporary/makeshift, damaged, unfinished structures or tents were less likely to have access to basic services and facilities including electricity and water, face a high risk of exposure to elements  ( high temperatures, inclement weather ) , and also safety risks due to lack of structural integrity or reinforcements. Due to the various safety risks, they are also more likely to face multiple displacements.
Findings from the majority of caseloads living in rental houses reported high levels of congestion, as multiple  ( up to 8 )  families were observed sharing single shelters to reduce cost per household.
Ancillary costs for patients, such a transport, are a further barrier to accessing healthcare, particularly in the current socio economic environment where people's coping capacities are eroded.
While COVID 19 has been in the spotlight throughout 2020, conflict remains the leading threat to both physical and mental wellbeing across Afghanistan.
In the current context of COVID 19, households living in congested shared shelters are at additional high risk for health concerns due to transmission of COVID 19.
However, it was observed in Balkh, Sari Pul, Takhar, Samangan and Kunduz that households made demonstrated efforts to reduce congestion and crowding in shelters following receipt of hygiene messaging from the Joint Assessment Teams  ( JAT )  in the area.
That said, host community members in Logar and Paktya expressed concern that services were overextended as a result of the influx of displaced households, leading to risk of exclusion of IDP households from basic services.
In areas under AOG control, community members reported that persons with GoIRA association felt fearful of returning to their AOO out of fear of being targeted, particularly persons having worked with the police, military or security elements.
For caseloads where assessment teams reported immediate threats to community and/or household safety, threats were generally linked to either conflict or natural disaster.
Of the 71 assessments, 20% reported immediate safety risks. Of those with safety risks, 43% were due to ongoing conflict or clashes, 43% were due to unsafe structures or exposure, and 14% due to criminality.
IDPs in Herat anecdotally reported 24 cases of community members killed during the armed clash that triggered their displacement, and another 12 reported to have died during the displacement process due to hardship and lack of healthcare.
Deaths were also reported as a result of armed conflict in Kandahar and Wardak. In Parwan, community members reported 4 persons killed and 2 injured as a result of flash flooding.
Across the majority of assessment sites, significant CP concerns resulted in psychosocial distress and reduced wellbeing for children; IDP children were the second most common group after women to display symptoms of psychosocial distress observed by assessment teams, including frequent crying, fear of noises, and aggressive behavior within a group.
Common forms of child labor observed include children involvement in agricultural labor, construction and manual labor, selling or reselling of goods in markets or along main roadways. Boys were frequently reported to be sent away to work, including some to Iran or to other provinces to work in opium production. This practice was most common in Herat, most likely due to proximity to the border.
While engagement in child labor has multiple negative impacts including reduced likelihood of children attending school, increased exposure to exploitation and abuse, and is linked to illness and malnutrition, certain forms of child labor are especially harmful due to their hazardous nature.
In Kandahar, child labor previously reported to be uncommon was observed to be increasing in frequency and reducing in average age  ( from 17 20 to 15 17 )  as a result of stressed household finances in the context of COVID 19 and a restricted overall economic environment.
A severe shortage of trained female doctors and midwives is also a major obstacle to extending reproductive health care to Afghan women.
Cases of forced child recruitment was reported to assessment teams in Zabul, Uruzgan, and Kandahar, with boys aged 12 – 22 and from households without a strong social network particularly at risk.
In Wardak, children were reported to be kidnapped on their way to and from school, likely resulting in reduced/lowered school attendance and severe impacts on affected children's wellbeing.
Disease outbreaks affect women and men differently, and pandemics make existing inequalities for women and girls and discrimination against other marginalised groups such as people with disabilities and those in extreme poverty, worse.
Camp like settlements further compound the risk of COVID 19 transmission and are not advised in this response.
According to community members, child recruitment continued to be a threat to households that do not have the resources to leave an AOO where recruitment is common or experiencing shifting frontlines, and particularly to those that do not have alternate sources of income that are safe and reliable.
Across all provinces, affected households reported early and forced marriage preexisting to their displacement, but increasing in frequency and reducing in average age due to stressed household economies as a result of displacement.
3 cases of early and/or forced marriage were reported in Herat, 1 in Kandahar, and 1 in Wardak.
Afghanistan continues to have one of highest rates of child stunting which has serious implications for children's long term physical and cognitive development.
During ERM assessments, where symptoms of psychosocial distress were displayed or suggested through community discussions, the majority of affected groups and individuals were female. The most common symptoms were distress and depression, with frequent crying observed and severe headaches and self harm reported.
In locations assessed by ERM teams, women and girls were frequently observed to be missing from the public sphere; in out of 71 assessment sites, girls were not seen in public or accessing services in 41%, and women not in 31%, indicating strong gendered power dynamics that are constricting the rights of women and girls in all regions of the country.
As a result, women and particularly widows struggled to access basic services, particularly healthcare and in emergency situations during the evening and night times.
In Herat, women and girls were reported to be actively restricted by male family members from accessing basic services, particularly healthcare. This was moreover reported to be impacting on poor maternal and child health outcomes, resulting in increased deaths of newborns.
Some 9 per cent of children under 5 have AWD, while there were 183 cases of Crimean Congo Haemorrhagic Fever  ( CCHF )  in the first 10 months of 2020, with some 15 deaths.
In 27% of assessment sites in all regions of Afghanistan, persons living with disabilities or the elderly were not observed in the public sphere. This absence can be a result of multiple factors, however anecdotal evidence from assessment teams indicated frequent stigmatization of the elderly and acutely or chronically ill as a result of COVID 19.
IDPs displaced to urban areas were predominantly sheltering in unfinished buildings, or renting properties within the host community.
Frequent destruction of property was reported in all regions, but due primarily to cases of natural disaster  ( heavy rains, flooding, landslides )  in Herat, Kunar, Badakhshan, Sari Pul, and Faryab. In Kandahar, Herat and Helmand, destruction of property was reported as a result of armed actors.
Due to converging vulnerabilities, ethnic minority female IDPs were the least likely to have their civil documentation.
In Kandahar, IDPs displaced from Urozgan reported limited access to documentation for all groups, due to complex procedures in place as well as high unofficial processing costs. As a result, many residents faced difficulty moving or accessing services.
While only directly reported to the ERM assessment teams in Kandahar, acquiring civil documentation is challenging across Afghanistan, and particularly for displacement affected households as GoIRA law for documentation for IDP or returnee status transfers burden of proof to applicants, is administratively complicated and costly
Affected communities in 45% of assessment sites reported partial access to basic services, but most commonly lacked education, WASH, and health services.
In addition to crowding, households also cited distance, security concerns, transportation costs and fees as prohibiting factors in access education services.
41% of assessment sites reported availability of most basic services, however in cases where services were available and functional, access was still limited as many were closed due to COVID 19. 14% of affected communities assessed reported that basic services were not available.
Overall, services were more likely to be available in GoIRA rather than AOG controlled areas. In the majority of assessment sites where IDPs were sheltering in host communities, services that were available were generally shared with IDPs, however host communities and IDP households in Logar and Baghlan voiced concerns that available services were stretched past capacity given the influx of IDP households.
Limited availability of fully trained medical professional and health workers has, at times, led to problems in laboratories which have been temporarily out of service due to contamination.
Conflict and direct attacks on health facilities and personnel regularly disrupt the provision of critical health care where these services do exist, leaving patients with unmet needs.
COVID 19 cases are concentrated in main urban centers and continue to grow rapidly
However, in urban AOD where services are more likely to be available, there was an observed trend in women reporting lack of knowledge in how to access available services.
Attacks against health also deter people from seeking care and create fear of approaching health facilities, adding to COVID 19 concerns which are now also a major deterrent to people attending hospitals and health clinics.
Regular monitoring of HLP issues should be undertaken and triangulated with flow monitoring data and intentions surveys of returning households to identify and advocate for solutions related to potential evictions.
As a result of the combination of limited access to services, limited labor or incoming generation opportunities, and high costs for living, many IDP household reported significant levels of stress in their AOD, and that they were unsure how they would make ends meet and provide for their families.
The aforementioned MSF report shows that postponing medical care due to financial pressure is a dangerous coping strategy adopted by 89 per cent of patients and carers surveyed.
Trauma care needs are highest in the south  ( Kandahar, Hilmand, Uruzgan and Zabul provinces )  where active conflict is ongoing, and in the north  ( Kunduz and Logar provinces ) .
Limits or restrictions on movements and denial of opportunities or services based on gender constitute socio economic, emotional and psychological GBV. Often these forms of GBV are prevalent in society as harmful elements of traditional practices, are difficult to root out, and are exacerbated in conflict and displacement environments.
Of 3,680 measles cases treated in the first seven months of 2018 by MSF, 48 per cent were admitted to the isolation ward due to severe complications which may have been prevented or controlled if care had been sought earlier.
Improving infection prevention and control is critical to overcoming people's fear of attending health facilities and restoring confidence among patients so that non COVID conditions do not go untreated and become more severe.
In the majority of assessment sites where education services were available, facilities were closed and services suspended due to COVID 19 restrictions, and in some cases insufficient to meet the needs of the hosting and displaced population if open.
HLP and/or legal assistance partners are encouraged to support and work with local authorities to improve access to civil documentation related to accessing deeds for proof of property ownership, and to engage in local authorities as duty bearers to advocate against occupation of displaced households' properties by AOG.
Humanitarian agencies are recommended to support IDP and returnee households with civil documentation assistance and counseling, and are suggested to explore the feasibility of using cash transfers in conjunction with legal assistance to ensure that HLP programming addresses cost barriers for populations at risk.
Mainstreaming of protection into shelter interventions, as a key way of reducing vulnerability to protection threats for households affected by damaged shelters through either natural disasters or conflict.
Increased integration of PSS into livelihood interventions through referrals to specialized service providers, coupled with mainstreaming of PSS considerations through community  level programming by ensuring responses are participatory, build empowerment, are safe and socially appropriate, protect dignity, and strengthen local support systems and networks.
Provision of information dissemination and training of community leaders on the rights of children, as well as the negative impacts of child labor is recommended.
Messaging is moreover recommended to include language encouraging reduction in stigmatization of affected groups to reduce emerging associated protection concerns and safe access to services.
Community leaders and community based networks are recommended to be engaged as change agents.
This means that polio transmission has become highly localised in pockets in the south and the east of Afghanistan. In the first 11 months of 2020, there were 255 confirmed cases of polio in the country.
Health partners continue to conduct assessments throughout the year. Under the guidance of MOPH, the Health Cluster has developed a guideline for emergency health services and corresponding assessment tools on trauma care and emergency health mobile health teams.
Consumption and investment have been compressed by social distancing measures and weak confidence. Revenue declines have constrained scope for effective counter cyclical fiscal policy to maintain economic activity over the first half of the year, with government spending declining over recent months as a result of both declining revenues and administrative disruptions to development project spending associated with social distancing measures.
Overwhelmed by the spread of virus, the already fragile public health system has faced shortages of medical equipment, personnel, and testing capacity.
Other barriers including the limited number of female frontline workers and counsellors, as well as the need for a Maharam to accompany them to access facilities, further contribute to the malnutrition burden.
The rate of infection subsequently accelerated rapidly, with an influx of returnees from Pakistan and Iran  ( around 150,000 Afghans retruned from Iran, one of the virus' global epicenters, during March ) .
However, more than 50 percent of millers and processing units relating to cereals  ( 50 percent ) , fruits  ( 57 percent ) , vegetables  ( 70 percent ) , and dairy  ( 97 percent )  were reported to be highly impacted and operating at reduced capacity or closed.
The nomadic Kuchis have also been severely impacted due to restrictions of access to pasture, lack of adequate fodder/feed and increased prices of the same, coupled with diminished access to assured veterinary services.
A significant number of small scale, provincial and national traders also reported restrictions in procuring fresh agricultural produce and difficulties in transporting produce to local markets due to increased transportation costs and road closures linked to very urgent and essential health related movement restrictions and containment measures.
Across all provinces, just over half of markets were reported as functioning as usual. Around 40 percent of wholesale vegetable markets appeared to have been affected adversely, while just about half of the total street vendors were functioning as usual.
Humanitarian partners are working with Provincial authorities to mobilise and expedite humanitarian assistance. Needs assessments are currently underway.
The great majority of traders reported increased prices for wheat, fresh food and transportation compared with 2019, while almost all the livestock traders across all provinces reported an increase in price of sheep/goat  ( by 25 percent )  and cattle  ( by 26 percent )  as compared with the same time last year.
The reported lack of access to certified/quality seeds coupled with the non affordability of quality fertilizers in local markets is a major concern for food security, considering that the planting of winter wheat, rainfed wheat, barley, and potato starts in September.
The spread of coronavirus in Afghanistan has amplified the need for people to have shelters with adequate space, running water and toilets.
To date, WHO has built the capacity of 190 teams on COVID 19 case definition, specimen collection, case investigation and advising confirmed cases on further course of action.
WHO has also supported the training of 1509 health workers on case management and intensive care and 960 health workers on infection prevention and control.
The United Nations is deeply concerned by both the increase in civilian harm and the striking deterioration of parties' respect for international humanitarian law, demonstrated by the recent shocking attacks on healthcare facilities and threats to healthcare workers, failures to take all feasible precautions in conducting airstrikes, and the use of large amounts of explosives in civilian populated areas.
“I call for a halt to the fighting and for parties to respect humanitarian law that is there to protect civilians,' said Deborah Lyons, the Secretary General's Special Representative for Afghanistan.
“Parties have committed to finding a peaceful solution and should protect the lives of all Afghans and not jeopardise people's hope for an end to the war,' said Lyons, who is also head of UNAMA. “Intra Afghan peace negotiations need to start as soon as possible.'
As of 25 August, Torkham border has been open on Mondays and Tuesdays for refugee returnee movements to Afghanistan.
Since 01 January, UNHCR assisted the return of 1,780 Afghan refugees from Pakistan  ( 940 ) , Iran  ( 786 )  and other countries  ( 54 )  including Tajikistan, India, Kazakhstan, Azerbaijan, and the Russian Federation, under its facilitated voluntary repatriation programme.
According to MoRR/IOM, during the weeks of 01   07 November, the total number of undocumented returnees from Iran was 23,640  ( 13,820 spontaneous returnees and 9,820 deportees )  and from Pakistan was 173  ( 163 spontaneous returnees and 10 deportees ) .
The gap in information dissemination in Torkham which was very high in August  ( 74% )  and September  ( 63% )  has improved  ( 42% )  subsequent to UNHCR's follow up with partners and with the adoption of a more regular border opening schedule from 28 September.
Similarly, the pandemic has also escalated household debt and negative coping mechanisms.
Due to COVID 19, on 14 March 2020 the government of Afghanistan imposed additional control measurements to prevent further spread of the virus. These included restrictions on movement within Afghanistan and the closure of main markets.
At the time of writing, many organisations continue to keep a proportion of their international staff outside the country, supporting the response remotely while national staff in country.
Following the regional inter cluster coordination meeting held on 26 August, the ES/NFI Cluster signaled capacity to immediately assist 1,000 families, with intent to scale up support to 2,500 families shortly.
Humanitarian organisations have deployed 21 joint assessment teams in Kunduz.
The World Bank has also engaged with humanitarian partners to ensure coordination of any response on their side.
While NGOs recognise the benefits of having a clear NGO Law in place that facilitates their work according to international best practice, such legislation must be enabling, allowing NGOs to serve the people of Afghanistan according to core humanitarian principles of transparency, operational independence, impartiality, and neutrality.
Despite considerable additional health investment and heightened need due to the pandemic, households continue to struggle to access health facilities. This is not just because there are an insufficient number of centres across the country but also because of the cost and dangers involved in reaching these centres and because they are sometimes forced to close because of violence.
The physical environment and lack of transport and communications infrastructure remain a challenge in Afghanistan, with road access impeded by conflict, poor road conditions as well as natural hazards, including seasonal flooding and heavy snowfall.
The conflict in Afghanistan still remains one of the deadliest in the world for civilians.
The terms of trade between livestock and wheat flour deteriorated by 10 percent from March 14 to April 30, mainly due to the increase in wheat flour prices.
The recently updated IPC analysis shows the food security situation has become worse during COVID 19. An estimated 16.9 million people, or 42 per cent of the population are now assessed as being in crisis or emergency levels of food insecurity  ( IPC 3+ )  for November 2020 – March 2021.
Despite the heightened pressure and need for their services, health facilities and workers continue to suffer harm from attacks, as well as acts of intimidation by parties to the conflict, undermining the system's ability to meet needs.
3.1 million out of 7 million children under five are estimated to be acutely malnourished in 2021, meaning almost half of children under five need life saving nutrition support, as do a quarter of PLW.
Ongoing conflict, recurrent natural disasters, chronic under investment in durable solutions, particularly in remote or contested areas, and more recently the need to shift humanitarian funding to the pandemic response, have further reduced access to critical services.
Wages for casual labor in main urban markets decreased by an average of 4 percent between February and March 2020 – driven by Kandahar and Maimana where wages decreased by over 10 percent – according to WFP data.
The ongoing conflict, COVID 19 and the challenging physical environment continue to directly impact on the ability of people in need to access life saving assistance and on the speed with which humanitarians can reach them with support. Despite these challenges, humanitarians continue find ways to stay and deliver, actually increasing reach during the pandemic.
WoA Assessment findings show that 8 per cent of displaced households indicate the presence of mines, ERW, and PPIEDs in their community and 29 per cent report the loss of or severely diminished access to basic services due to non COVID events, such as active conflict.
In the Southeast region, physical and psychological abuse are most prominent, both constituting 37% of the GBV cases in the region.
The economic impact of COVID 19 is also translating into increased criminal activity, with financial pressures possibly leading to more criminally motivated actions against humanitarians, including 12 incidents by community members in quarter three of 2020 compared to 3 and 5 incidents in the first and second quarters respectively.
In a longer term approach, it is vital that GBV and human rights awareness begins from the very childhood within Afghanistan. This initiative would yield a more positive attitude towards the role of Afghan women and girls within Afghan society and as equals to their male counterparts.
Less than a quarter  ( 22 per cent )  of displaced households reported that their children attended school fewer than four days a week prior to the COVID 19 outbreak, compared to 11 per cent of refugee households and 8 per cent of vulnerable non displaced households.
Based on data from the Food Security and Agriculture Cluster  ( FSAC ) , an estimated 484,000 individual were reached with full rations of humanitarian food assistance in February 2020, with the largest caseload reported for Kabul province  ( 104,800 individuals ) , followed by Farah  ( 69,000 ) , Balkh  ( 56,400 ) , Kunar  ( 48,900 ) , Khost  ( 48,600 ) , and Badghis  ( 40,500 ) . Since November 2019 when 56,000 individuals were reached nationally, the number of beneficiaries reached per month has steadily increased.
Household air pollution is particularly acute during the winter as thousands of families burn plastic, car tyres and raw coal in their stoves for heating.
Many assessed households, particularly refugee households or those headed by a person with a disability are facing problems with energy and heating heading into the 2020 2021 winter.
There are regional variations with 11 per cent of displaced households in Sar e Pul, 6 per cent in Hirat, and 6 per cent in Uruzgan reporting that they have no energy source for winter.
Despite years of conflict, intermittent closures due to COVID 19 and a temporary closure of borders stopping the cross border movement of commercial goods, markets in Afghanistan remain remarkably functional and able to meet consumer demands. However, the impact of COVID 19 has pushed the price of staple goods higher and purchasing power down, diminishing people's ability to buy enough food to meet basic nutritional needs.
While estimates of the country's population have almost doubled over the last twenty years, safe drinking water coverage in Afghanistan continues to be limited and is still among the lowest in the world.
The constant interruptions to education due to conflict, displacement and COVID 19, as well as the inadequate availability of schools and teachers have grave consequences for children's capacity to thrive and find work into the future.
Almost two thirds  ( 63 per cent )  of households headed by a person with a disability were classified as being within the “emergency' level of the LCS Index, compared to 40 per cent of other households.
However, data suggested that households headed by women found it even harder for someone in their household to find work after the lockdown was lifted in August and September 2020, suggesting livelihood impacts are severe and long lasting.
Among the security challenges reported, navigating explosive hazards has been particularly highlighted in Samangan and Uruzgan where up to 70 per cent of key informants reported the presence of explosive hazards as barrier.
Prior to the COVID 19 outbreak, the majority of vulnerable people in Afghanistan relied on the informal sector for employment, leaving them to depend on unstable and irregular sources of income to support their household's basic needs.
Of those displaced households that reported struggling to obtain food or meet their food needs, the most common coping mechanisms being used or already exhausted within the last 12 months were borrowing food or money for food  ( 80 per cent ) , increasing daily labour  ( 58 per cent ) , decreased expenditure on health, education, and other services  ( 53 per cent )  and migration to look for work  ( 34 per cent ) .
With the onset of COVID 19 and restrictions on movement, informal employment opportunities largely dried up, resulting in overwhelming loss of income sources and decreased access to food.
Across different population groups between 25 and 44 per cent of 2020 WoA assessed households reported that they could not find work for 5 or more days per week before the COVID 19 lockdown; while 8 12 per cent of assessed households reported they could not find work at all.
The death and sickness of male breadwinners has also placed increased pressure on family incomes, given the limited options available to women.
Predictably, households headed by a person with a disability or refugees, for whom employment opportunities are limited due to documentation and physical access challenges, were found to employ negative coping strategies at elevated levels.
In particular, households headed by a person with a disability were more likely to report borrowing money to buy food than other displaced households  ( 92 per cent compared to 83 per cent ) .
Child mortality, malnutrition, forced marriages, sexual abuse, child labour and other forms of violence and exploitation and are all common challenges for the average child.
While the WoA Assessment found high use of negative coping strategies by both vulnerable households headed by men and women, the options available to each often differ, with women often having fewer resources and opportunities to draw on in a time of crisis. For example, 66 per cent of households headed by women reported that selling income generating equipment was not applicable or not available to them  ( compared to 45 per cent of male headed households ) , 69 per cent of households headed by women reported that spending savings was not applicable or not available to them  ( compared to 45 per cent of male headed households ) , 64 per cent of households headed by women reported that selling their last female animals was not an option available to them  ( compared to 42 per cent of male headed households ) , 70 per cent of households headed by women reported that selling land was not applicable or not available to them  ( compared to 47 per cent of male headed households ) .
94 per cent of refugee households and 93 per cent of vulnerable non displaced households report having debt while 71 per cent to 87 per cent of all displaced households report having debt, depending on the duration of their displacement.
While all provinces have high levels of debt, displaced households in Khost, Bamyan, Baghlan, Parwan, Logar, and Badghis all report average debt burdens above 70,000 AFN/$909.
Health facilities and workers continue to suffer harm from attacks, as well as and acts of intimidation by parties to the conflict, even as there is heightened need for their services due to COVID 19.
According to a study commissioned by the European Union, approximately half of the population in Afghanistan experiences depression, anxiety or post traumatic stress due to violence.
Along with the immediate impact of displacement on the financial and social wellbeing of households, displacement leaves people further exposed to explosive hazards that contaminate large parts of the country.
Active conflict, large scale population movements, recurrent natural disasters and the ongoing impact of COVID 19 on the social and economic fabric of the country have hindered longer term urban planning, reduced attention on more expensive durable solutions and diminished people's access to essential services.
Facing unprecedented demand and multiple waves of the virus, hospitals and clinics continue to report challenges maintaining or expanding their facilities' capacity to treat patients with COVID 19, as well as maintaining essential health services, especially in areas of active conflict.
Furthermore, despite constraints noted above, partner reach in 2020 has expanded to cover 39896 of Afghanistan's 401 districts, demonstrating the humanitarian community's determination to not just stay in country but also to deliver, even in hard to  reach districts.
At the same time, active conflict and the intentional targeting of health facilities and staff by parties to the conflict has led to the periodic, prolonged, or permanent closure of critical health facilities, impacting as many as 1.2 million people across at least 17 provinces in the first ten months of 2020.
Additional resources to expand current community engagement, surveillance, and contact tracing efforts, equip medical facilities and frontline staff with PPE, and support expanded testing and rollout of anticipated vaccines are urgently needed in 2021.
While 2,000 beds have been made available for isolation and intensive care, medical equipment has been provided for 1,642 isolation beds, 1,778 oxygen concentrator machines have been supplied and some 98 ventilators have been delivered,111 this is only sufficient to cover a small fraction of needs in a country of 40.4 million people.
In Kabul informal settlements, 13 per cent of women headed households rely on begging to survive.
Most households report extreme coping mechanisms with more than 61 per cent of shock affected households reducing money spent on food and other expenditure such as for healthcare, to survive the winter.
The costs of kinship and community support are high. Nearly a quarter of refugee households report going into debt due to the cost of hosting displaced household members.
The level of vulnerability increases for people with specific needs. Women, the elderly, adolescents, youth, children, people with physical and mental disabilities, refugees, migrants, and minorities experience the highest degree of socio economic marginalisation, especially in the winter.
Approximately 68 per cent of affected households report borrowing money or going into debt during the winter.
More than half of shock  affected IDP households, and one in four households overall, reported feeling unsafe, most commonly due to natural disasters in general, or shelters failing during natural disasters.
Similarly, across other population groups, 86 per cent of recent IDPs, 94 per cent of refugees, 74 per cent of returnees and 67 per cent of acutely vulnerable people reported having either severe or critical ES NFI needs.
Shelter needs alone  ( both emergency and transitional )  are reported to be the highest among refugees  ( 50 per cent ) , followed by non recent IDPs  ( 37 per cent ) , recent IDPs  ( 36 per cent ) , cross border returnees  ( 30 per cent )  and acutely vulnerable people  ( 21 per cent ) .
Refugees reported deeper needs than any other population group with more than 50 per cent in need of emergency and transitional shelter support alone.
Provide more information to IDPs regarding the free access to humanitarian services.
Advocate for scale up of ICLA interventions to support access to Tazkera and other legal services.
In March 2020, NRC conducted 148 household level protection monitoring interviews which targets 48% female and 52% male respondents. 76% of interviewees reported not receiving any threat of eviction while 24% reported having received threat of eviction. The eviction notice are reported to originate from the private land lords, the IDPS a settled private land.
Due to the COVID 19 lockdown measures imposed by Government, IDPs are faced with challenges in accessing food and income opportunities.
An analysis of SMART surveys conducted between 2015 and 2019 across Afghanistan showed that a staggering 15.3 per cent of infants under 6 months in Afghanistan are affected by wasting, 6.2 per cent of whom are severely wasted.
Afghanaid is implementing the emergency agriculture and livelihood assistance project supported by FAO, supporting 12,400 food insecure farming families across Feruzkoh, Shahrak, Lal wa Sarjangal, and Dulaina districts of Ghor province. The project is delivered over a nine month period  ( March – December 2020 ) .
Thanks to the generous support from the Government of Sweden 3,200 vulnerable female headed households are supported to bolster their livelihoods and improve their food and nutrition security through home gardening activities.
Analysis of Mid Upper Arm Circumference  ( MUAC )  screening data for the first 9 months of 2020  ( Jan   Sep 2020 )  indicated a worsening nutrition situation in 13 provinces compared to the same period in 2019.
About a fifth of people falling into IPC 3 and 4 categories of food insecurity are children under five who are then at risk of malnutrition.
Provinces where high prevalence of GAM, combined with prevalence of crisis and emergency phases of food insecurity  ( IPC 3 and 4 ) , high levels of stunting, low exclusive breastfeeding, poor maternal nutrition, low immunisation coverage and high level of childhood morbidity are considered priority areas with high nutrition needs.
The Nutrition Cluster conducts periodic provincial and localised, integrated SMART nutrition surveys which allow collection of sex and age disaggregated data on children and women's nutritional status, as well as on determining factors such as household food insecurity, morbidity status of children, access to health, and water, hygiene and sanitation services.
Conflict affected non displaced people are also vulnerable to this threat as explosive ordinance is frequently left behind after fighting. The situation has further worsened with recent surge in in conflict in the final quarter of 2020, which is not expected to improve in 2021.
Consequently, gendered land rights constitute a major cause of gender based asset inequality, particularly given that land is often a household's most valuable asset.
A recent study by the Norwegian Refugee Council  ( NRC )  conducted among IDPs, refugee returnees and host communities in Kandahar  ( in May 2020 ) , for example, highlighted that more than 80 per cent of those surveyed in Kandahar reported threats of eviction due to inability to meet rental payments.
A key driver of increasing HLP needs is the increasing number of IDPs not returning home and requiring land in new locations to rebuild their lives.
Areas in the country's south  ( Kandahar, Hilmand, Zabul and Uruzgan provinces ) , south east  ( Ghazni, Paktya and Khost provinces ) , east  ( Nangarhar and Kunar provinces ) , north  ( Faryab province )  and west  ( Farah province )  are the most affected. These 11 provinces made up 69 per cent of Mine and ERW casualties between 2011 and 2020.
Furthermore, the Hard to Reach  ( HTR )  areas assessment between July and August 2020 suggests that the presence of explosive hazards significantly hinders access to basic services.
Of the 41 per cent of key informants who were aware of explosive hazards in or within 5km of their settlement, 47 per cent reported that explosive hazards have constrained their access to basic services in their settlements in the preceding three months.
307 reported security as a main barrier to education.
A further 53 per cent said that explosive hazards hindered children's access to recreational activities and nearly a third of households assessed as part of nationwide PDM.
People living in rural areas of Afghanistan have lower access to water and sanitation facilities.
IDPs, disaster affected people and those living in conflict prone areas are the groups most exposed to risks from unsafe water sources, lack of hygiene and unimproved sanitation facilities.
IDP children are particularly affected, with some 33 per cent of children under five years having experienced AWD in the two weeks prior to the 2020 WoA Assessment
Moreover, facilities adapted for people with disability are often unavailable, making this group susceptible to high risks associated with safety and dignity.
In the WoA Assessment, 39 per cent of displaced households reported at least one area where women and girls feel unsafe.
The COVID 19 crisis has emphasised and exacerbated the vulnerability of the poorest people and IDPs, including many in urban areas who require improved sanitation and hygiene options.
Cluster analysis shows more than 35 per cent of health care facilities and schools have no reliable access to water supply and sanitation services to facilitate quality education to children and health care services to patients.
Displaced groups, including IDPs and returnees, typically suffer very high tenure insecurity because they have no other option but to occupy land  ( often privately owned )  with insecure property rights.
CARE conducted a Rapid Gender Analysis in Afghanistan in mid 2020. Sixty two per cent of respondents said food is their highest need.
Policy measures to contain the spread of the virus, including border closures and lockdowns, have had a large and immediate negative economic impact.
Government and donor resources were mobilized to establish and repurpose a number of new laboratories, testing faciltiies, and treatment centers in cities with high numbers of cases. As of June, Afghanistan's COVID 19 testing centers had capacity to undertake 790 tests a day, with eight hospitals allocated for exclusive use by COVID 19 patients.
Slow growth in industry and services reflected weak confidence associated with the presidential elections, continuing conflict, potential declines in international security and development support, and the uncertain outcome of peace discussions with the Taliban.
Following the imposition of lockdowns in urban areas, travel to retail stores, transit service locations, and workplaces remain more than 50 percent below pre lockdown levels. Grocery stores have seen a decline in the number of visitors by around 40 percent compared to baseline levels.
Further exacerbating the food insecurity situation is the rapid spread of COVID 19 since April, with a reported test positivity rate  ( positive tests as a percentage of total tests )  of more than 44 percent.
The provinces of Badakhshan and Daykundi along with Herat and Kandahar city centres have been particularly hard hit and are classified as being in an emergency state of food insecurity  ( IPC Phase 4 ) .
Ministry of Public Health  ( MoPH )  data  ( August 2020 )  shows that 37,999 people across all 34 provinces are now confirmed to have had COVID 19 and 1,387 people have died.