nlp-thedeep/humsetbias huggingface dataset:
Similarly, the Nutrition Cluster's analysis of recently carried out SMART surveys has led to an increase in people in need from 4.6 million people in mid 2020 to 5.4 million in 2021. This has been driven by a surge in number of children under five and PLW who require urgent nutrition support, partly due to food insecurity and delayed treatment in 2020.
Conflict now shapes daily decision making for civilians about movements and access to services, posing terrifying protection risks but also having a devastating impact on the country's development and infrastructure.
Eight per cent of displaced households  ( compared to four per cent of refugee and 1 per cent of vulnerable non displaced households )  reported marrying a daughter earlier than intended in the preceding 30 days due to a lack of money to buy food.
The confluence of escalating conflict, natural disasters, COVID 19 and related interruptions or unavailability of services have increased the severity of existing gender gaps affecting women and girls in general, but specifically for women IDPs, women and girls with disabilities, older women, women headed households, and women living in rural and remote areas.
Quarantine measures, school closures and restrictions on movement have disrupted children's routine and social support structures, while also placing new stressors on parents and caregivers who often have to find new childcare options or forgo work.
Attacks on schools have undermined the right of children to a safe learning environment, compromising their physical and psychological wellbeing. While these figures are likely to be a gross under estimation of violations against children and cannot capture the full scope of child  related protection concerns, the numbers highlight persistent worsening trends facing one of the country's most vulnerable demographics.
Despite the serious barriers to healthcare facing many Afghans, a cost recovery approach, implemented through the collection of user fees in some public secondary and tertiary medical facilities in the country, started to be enforced in December 2018.
From July 2019 to June 2020, the UN verified 1,497 such violations against children, including 1,164 incidents of killing and maiming, 155 attacks on schools and across 16 provinces, and 326 children recruited to armed forces and groups across 31 provinces.
Nutrition treatment was compromised due to COVID 19 movement restrictions in 2020, in addition to low turnout as a result of community fears of catching the virus in nutrition treatment facilities that are often co located in health centres.
Attempts to overcome changes in health seeking behaviour and social distancing requirements by delivering mobile services have been made across the response, however these are more expensive than fixed facilities and are not able to reach the same number of people with the same depth of assistance. This also has flow on implications for needs in 2021.
With little indication a cessation of hostilities or a sustained humanitarian ceasefire is on the horizon in 2021, it is estimated that as many as 310,500 trauma cases will require emergency medical treatment as a result of continued and escalating conflict.
Recent analysis by the Nutrition cluster revealed an increase of 13 per cent in cases of SAM.
Nearly one in two children under five  ( 3.1 million children out of 7 million )  and one in four PLW is now facing acute malnutrition and requires life saving treatment services.
Pre existing shelter and Non Food Item  ( NFI )  needs driven by decades of conflict, recurrent natural disasters and the sustained erosion of communities' resilience have been further compounded by the outbreak of COVID 19 and the implementation of related containment measures in 2020.
Although, it should be noted that the result for Parwan was most likely skewed by the timing of data gathering which coincided with severe flooding in this location, elevating needs at that particular time.
The updated IPC analysis published in November 2020 shows the food security situation has further deteriorated during COVID 19 due to a confluence of factors including: reduced daily wage opportunities and small trader income, ongoing conflict leading to displacement and loss of livelihood, higher than usual prices for key commodities, and floods.
Potentially compounding vulnerability, 53 per cent of women  headed households reported having only a verbal rental agreement, compared to 36 per cent of male headed households. This insecurity of tenure is particularly concerning in informal settlements on the fringes of urban centres where many IDPs and returnees live on private land, paying rent without formal property rights.
Afghanistan is facing a severe food insecurity crisis with levels now rivalling the devastating 2018  2019 drought and the world's second highest IPC 4 population with 5.5m people in emergency food insecurity.
Conflict is driving civilian deaths and injuries, destroying life  sustaining civilian infrastructure – including the critical facilities developed to treat physical and mental health needs    and triggering displacement.
MoPH notes that issues of access to services for newly impacted people and continuity of care for people with developing or existing mental health conditions, along with the mental health and wellbeing of frontline workers, have become major concerns.
Across the country, the need for new or improved shelter is reported by affected populations as their second highest priority need after food.
According to a UN Women and International Rescue Committee  ( IRC )  study, 78 per cent of women surveyed reported that their mental health had been affected by ongoing conflict and compounded by COVID 19.
At the same time, access to mental health care or psychosocial support remains out of reach to many, particularly in rural areas.
Four decades of uninterrupted conflict, recurrent natural disasters, endemic poverty and now the COVID 19 pandemic's fallout have taken a brutal toll on the mental health and personal resilience of the people of Afghanistan.
Across the country, WASH systems have faced under  investment and disruption, which in turn generates complex needs that only worsen the burden on the health system.
In 2020, COVID 19 severely interrupted these kinds of rehabilitative and prosthetics services, slowing the recovery of those with disabilities and prolonging their suffering. This backlog will have lingering effects into 2021.
Around a third of displaced households  ( 35 per cent )  and vulnerable non displaced households  ( 30 per cent )  report loss of or severely diminished access to services due to COVID 19.
Of those who reported a barrier to access to markets, 51 per cent reported markets being too far or not having transport available, 13 per cent reported the roads being too dangerous due to conflict, 8 per cent reported roads being too dangerous due to physical constraints; 12 per cent reported markets not being accessible due to COVID 19 restrictions.
In a deteriorating trend from the beginning of the year, findings of the most recent nutrition surveys show that 27 out of 34 provinces are now within the emergency threshold for acute malnutrition; 10 provinces are facing critical situations.
Across all demographics, girls are disproportionately denied educational opportunities. Their access to education is limited by cultural factors and the scarcity of qualified female teachers, especially in remote and hard to reach areas.
This comes alongside data from the WoA Assessment showing that household debt is rapidly escalating in terms of both the number of people in debt and the scale of that debt.
Unfortunately, 4 healthcare workers have been killed, 5 injured, and 13 detained; 51 health facilities are no longer functional due to destruction  ( 2 ) , damage  ( 9 ) , looting  ( 2 ) , or closing due to persistent conflict  ( 38 ) .
In 2020, more than 500,000 returnees were screened for infectious diseases, including COVID 19 and tuberculosis.
The Global Age Watch Index has consistently rated Afghanistan as one of the worst countries in which to live for the elderly. This analysis looks at a variety of indices such as income security, health status, capability, and enabling society and environment.
The stress of poverty and unemployment followed by food insecurity, low access to WASH and hygiene materials, and the high burden of care for the sick and for children has impacted on the overall living conditions of people in Afghanistan, which has indirectly triggered GBV cases and mental distress.
There has also been a trend of people being reluctant to attend fixed health and nutrition facilities where they do exist, due to fear of catching COVID 19 due to gaps in infection prevention and control measures.
The socio economic impact of the pandemic is exacerbating pre existing gender inequalities driven by harmful norms and stereotypes.
The majority of civilian casualties are from ground engagements where the use of indirect fire  ( mortars, rockets, and grenades )  in populated areas makes it impossible for civilians to avoid conflict areas.
Given the convergence of heightened climate risks, food insecurity, poor preparedness and susceptibility to damage due to earthquakes, the Inter Agency Standing Committee  ( IASC )  Asia Pacific Regional Directors have agreed that Afghanistan is now the most at risk country in the region and should be upgraded as a global concern.
A contingency plan developed by the Inter Cluster Coordination Team  ( ICCT )  in late 2020 estimates that if an earthquake of 7.6 magnitude were to strike the seismically risky area between Kabul and Jalalabad, up to 7 million people would be impacted in the areas of worst shaking, throwing three million of the most vulnerable people into humanitarian need.
Challenges for women to access markets remain, with four per cent of key informants reporting that women have no access and 36 per cent reporting they have access only when accompanied by a man.
In the last 10 years, more than 7,000 people have lost their lives because of earthquakes in Afghanistan, with an average of 560 fatalities per year.
Displaced households headed by a person with a disability reported a median net income of  2,000 AFN, which is 4 times lower than that of the displaced households headed by people without a reported disability.'
Electricity supplies have been especially unreliable in 2020 including in Kabul.
However, child labour does seem more concentrated in a few provinces. Displaced households in Farah and Hilmand reported particularly high levels of child labour for boys, instead of going to school.
Some 45 per cent of women refugees and 40 per cent of women IDPs noted an increase in the time spent on water carrying since the pandemic.
The pandemic has further exacerbated the time it takes to collect water.
Another 27 per cent reported the distance to water points as a main concern and 23 per cent reported not enough containers to fetch and store water.
Nearly half of all displaced households do not have access to water within 30 minutes of home, while some 45 per cent report insufficient water for hand washing or improved sanitation.
The sanitation situation also remains poor with 45 per cent of people unable to access proper latrines.
The 2020 WoA Assessment shows that 8 per cent of shock affected people had at least 1 child between the ages of 11 17 working outside the household 30 days prior to the survey. This figure jumps to 13 per cent for IDP and returnee households.
Civilian casualties due to explosive devices have consistently risen since 2012. Almost two thirds  ( 57 per cent )  of these incidents are due to improvised mines, followed by ERW.
Returnees are also a group at risk, often having limited knowledge of the area they are returning to/ through and being at high risk of encountering ERW/landmines.
Patriarchal norms, which are prevalent throughout the country, cause violence against and restrict the movements of women outside the home.
The socio economic pandemic has fuelled harmful coping mechanisms such as child labour, early marriage and child recruitment, while simultaneously straining the capacities of families and communities to protect children.
Child recruitment cases were most prominent in the country's northern and north  eastern areas and are likely to remain an under estimation.
2020 saw a three fold increase in cases of recruitment and use of children by armed forces as compared to 2019.
In 2021, some 12.8 million people  ( 3,274,974 men, 2,842,262 women, 6,675,853 children and 1,138,585 people with disability )  are in need of protection assistance to prevent avoidable deaths and maintain their safety, dignity and rights.
The Nutrition Cluster's analysis of aggravating factors revealed provinces with high levels of acute malnutrition concurrently have a higher proportion of acutely food insecure people  ( over 42 per cent of people classified as being in crisis and emergency phases of food insecurity  ( IPC phase 3 and 4 )  ) ; higher rates of stunting among children under five; higher rates of diarrheal morbidity; low rates of exclusive breastfeeding; and poor maternal nutrition status ) .
Further analysis of SMART survey data  ( 2015–2020 )  indicates a significant proportion of children under five are also ‘borderline' in terms of acute malnutrition status.
Nutrition treatment was compromised due to COVID 19 movement restrictions for a period of months in 2020, in addition to low turnout as a result of community fears of catching the virus in nutrition treatment facilities that are often co located in health centres.
The cost of medicines is also an issue suggesting that there is a need to support people to purchase the drugs they are prescribed when they do see a doctor.
Since Intra Afghan Negotiations began on 12 September 2020, additional discussions have been initiated among sub regional stakeholders on the potential for facilitating the large scale return of Afghan nationals from Pakistan and Iran in 2021 in line with the Government of Afghanistan's post peace priorities. This would, however, need to be based on the principles of safe and voluntary return.
Lack of progress in passing proposed legislation on asylum has left refugees in Afghanistan without the necessary legal documentation to enable them to move freely throughout the country, work in the formal sector, pursue higher education, or enter into contracts, leaving them dependent on humanitarian assistance and remittances to meet basic needs.
Lack of documentation also presents challenges to accessing health care  ( although not a legal requirement ) , the formal education system, statutory justice systems, mobile phone services and the attainment of credit from banking institutions.
However, while parties are negotiation towards lasting peace, in the short term efforts by the Taliban to secure a strengthened position from which to negotiate continue to drive local violence and have displaced thousands of families from their homes.
Adhering to WHO's physical distancing protocols, partners adopted remote psychosocial support  ( PSS )  approaches. Tele psychosocial support was provided through online and hotline services, including to those at risk or affected by COVID 19. In the meantime, frontline workers were trained on psychological first aid in order to provide first phase PSS to people affected by the crisis.
Misinformation continues to circulate, affecting people's ability to accurately identify the source of transmission, adopt mitigation measures and seek treatment. Reports indicate that stigma and misinformation are driving people away from essential health services that will lead to further morbidity and mortality. Further tailored engagement with different communities is critical to ensure COVID 19 prevention and mitigation measures are maintained and essential services are utilised.
Owing to the COVID 19 pandemic, the number of people requiring food and livelihoods assistance increased from 6.7 million to 9.7 million in the June HRP revision, with a matching increase in the funding requirements  ( $370 million, up from $279 million ) .
Contextual developments during the quarter centered around advances in the peace process, with deliberations ongoing between parties in the wake of the signing of a conditional agreement between the United States Government  ( USG )  and major Non State Armed Group – Taliban  ( NSAG TB ) . Following stalled negotiations for a prisoner release between the Government of the Islamic Republic of Afghanistan  ( GoIRA )  and NSAG TB, a spike in insurgent violence by AOG including NGAG TB and Non State Armed Group – Islamic State Khorasan  ( NSAG ISK )  against both military and civil installations including health facilities, prompted continued hostilities in provinces across Afghanistan, including Balkh, Helmand, Kabul, and Nangarhar.
Fighting between Non State Armed Groups  ( NSAGs )  is also is generating new humanitarian needs and is likely to further complicate developments over the year ahead.
Despite the risk of increased intimate partner violence and other types of GBV in line with the pandemic, there has been a reduction in self reporting of GBV incidents to service providers.
On 5 November, 200 families  ( approximately 1,400 people )  were reportedly displaced in Nazyan district, Nangarhar province due to ongoing clashes between the ANSF and NSAG.
Some 2,700 children  ( 39 per cent of the planned reach in this area )  accessed specialised case management support. These include unaccompanied and separated children, children survivors of GBV and children in in contact with the justice system. Child Protection partners reached 43 per cent of the Sub Cluster's PSS target.
To ensure operational preparedness for any deterioration in the security situation and significant new displacement, the inter cluster coordination team  ( ICCT )  is producing a quarterly stock pipeline tracking snapshot, to provide early warning of looming pipeline breaks and to support donor advocacy so that needs can be met.
Finally, household debt was also found to be strongly correlated to vulnerability in terms of sectoral needs, with the proportion of households with multiple sectoral needs increasing as the level of debt increased. Seventy two per cent of households with a high level of debt  ( > 200,000 AFN )  had two or more sectoral needs compared to 56 per cent of households with no debt.
Nutrition partners also engaged religious leaders on COVID 19 awareness raising, prevention, and COVID 19 risk communication.
Physical distancing measures have significantly decreased the capacity of healthcare workers to provide mental health and psychosocial services in static facilities.
The global shortage of supplies, including PPE, ventilators and other equipment has limited the capacity of healthcare workers to respond in a safe and effective manner. This is particularly a challenge in countries like Afghanistan where the health system is already overstretched.
Polio has now spread to new areas  ( Badakshan, Balkh, Badghis, Baghlan, Farah, Hirat, Nimroz and Laghman )  indicating people's declining immunity.
Armed clashes continued between ANSF and an NSAG mainly in Balkh, Faryab, Sar e Pul, Jawzjan and Samangan provinces and reported security incidents increasing compared to the previous week.
The Afghan Landmine Survivor Organisation also notes that people with disabilities are particularly at risk to the adverse impacts of COVID 19 because they have restricted access to vital health care, information and opportunities for meaningful participation in decision  making, and face increased risks of experiencing violence.
Disaster can also be a cause of injury that, in turn, contributes to increased numbers of people with disabilities.
While not all people with a severe disability need humanitarian assistance, those in this category face additional barriers to accessing support when they do, particularly women and girls.
Severe disability is more prevalent in women  ( 14.9 per cent )  than men  ( 12.6 per cent ) .
Since 16 August, fighting between the Taliban and Afghan National Security Forces  ( ANSF )  in villages of Khanabad district along the Kunduz Khanabad highway, Imam Sahib district, and Kunduz city, all in Kunduz province  ( OCHA 27/08/2020 ) , displaced approximately 64,000 people within these areas; approximately 28,000 were identified in assessments as requiring immediate lifesaving assistance.
Given the health and economic impacts of COVID  19, the need for a vaccine to be urgently rolled out cannot be overstated.
While the direct and indirect impacts of conflict and COVID 19 on healthcare have been felt by the entire country, 2020 WoA Assessment findings indicate that disruption to the healthcare system may have a greater effect on households headed by the disabled, the elderly, and by women.
Similarly, the emergency response to COVID 19 also means that resources for sexual and reproductive health services may have been diverted to deal with the outbreak, contributing to a rise in maternal and newborn mortality, increased unmet need for contraception, and increased numbers of unsafe abortions and sexually transmitted infections.
The imperative to shift health resources to pandemic response, preparedness, and prevention activities, combined with movement restrictions intended to mitigate against the spread of the virus has inadvertently resulted in a de prioritisation of other critical health activities, such as routine screening for PLW or treatment of chronic illnesses, with long term consequences.
An inter sectoral analysis of needs in Afghanistan reveals a clear pattern of overlapping sectoral requirements, which is intensified by conflict, displacement  ( frequency and duration )  and vulnerability factors.
Despite the scale up in COVID 19 prevention and response activities in 2020, a joint MoPH, Johns Hopkins, WHO study extrapolated that approximately one third of the population may have caught COVID 19 by June 2020.
Between January and October 2020, direct targeted attacks on health facilities and health workers constituted 78 per cent of all attacks on health care.
Agricultural land and public infrastructure have also been impacted.
Food security and agriculture needs have also increased substantially  ( 4.9m in 2019, 8.2m in 2020 )  due to a combination of factors, including the lingering impact of the drought, the wider definition of vulnerability and a better understanding of needs in urban areas.
Health Cluster partners scaled up the COVID 19 response while maintaining essential health services  ( later added as a ninth pillar ) . The Health Cluster response had to shift to mobile based delivery modalities in many areas to adhere to physical distancing requirements, to offset the effects of stretched static facilities and account for the reduced health seeking behaviour being shown by community members.
Some 170,009 children were enrolled in Community Based Education  ( CBE )  programmes despite schools remaining closed since the onset of the pandemic and 54,312 children were able to access education services through home based self learning and small group learning programmes.
Despite these challenges, some 120,649 children under 5 years were successfully treated for SAM and MAM through integrated Mobile Health and Nutrition Teams and static health facilities. A further 439,629 women and children were served through Therapeutic Supplementary Feeding and another 138,868 women and children under 5 years through Blanket Supplementary Feeding.
In response to the COVID 19 pandemic, the Health Cluster established 12 laboratories across the country – having the capacity to undertake more than 2000 tests a day. Some 2,000 beds were made available for isolation and intensive care across the country. Through a network of health workers and the re deployment of 34,000 polio volunteers for COVID 19 activities, health partners rolled out a surveillance system that tracked almost half a million people and screened more than 480,000 people at border points. Trained community health and first aid volunteers reached 857,000 people with psychosocial first aid across 30 provinces.
The use of cash has continued to play a growing role in humanitarian response in Afghanistan in 2020. In the first half of 2020, humanitarian partners report distributing approximately US$34m in cash assistance. Recognising the need to strengthen market monitoring, the Cash and Voucher Working Group  ( CVWG )  worked closely with the REACH Initiative to develop a Joint Market Monitoring Initiative  ( JMMI ) .
The COVID 19 outbreak has highlighted the ability of Awaaz to adapt quickly to different crises. It is serving as a key, two way information platform for affected people with questions about COVID 19. During the first half of 2020, Awaaz's operators directly handled over 26,002 calls from all 34 provinces, 2,872 of which were directly related to COVID 19. Awaaz also developed a specific dashboard for COVID 19 data, in addition to its regular summary, that is updated weekly and includes general information on the number and topic of calls.
Nutrition cluster partners reached 100,619 children and 38,249 pregnant and lactating women with basic supplementary feeding  ( BSF )  and expanded eligibility of infant and young child feeding  ( IYCF )  assistance to include children ‘at risk' of malnutrition.
Based on the common analysis, an estimated 93 per cent of people were considered in need of an emergency safety net to help them survive the impacts of COVID 19.
While there was a slight improvement from the previous projection, in which 14.3 million people  ( 38 per cent of the population )  were categorised as being severely food insecure until March 2020, the number of people in “emergency' levels of food insecurity has worryingly increased from 3.4 million to close to 4 million people.
Protection partners modified prevention, awareness raising and case management approaches from group meetings to door to door outreach and individual engagements, while also using community networks and existing staff to provide awareness raising activities to over 533,000 people. Recognising the significant impact of the pandemic on people's mental health, Protection Cluster partners developed innovative ways to provide tele psychosocial support and to increase psychological first aid  ( PFA )  training for frontline staff. Given the prevalence of Gender Based Violence  ( GBV )  in Afghanistan and evidence suggesting increased incidents of GBV at the household level during COVID 19, GBV partners also scaled up their survivor centred, multi sectoral response through increased PSS outreach teams, cash interventions to support access to GBV services, referrals and economic empowerment assistance.
UNICEF appealed for USD70.05 million in 2020 to sustain the provision of life saving services for children and women in Afghanistan. During 2020, UNICEF received USD27 million including USD14 million of carried over funds from 2019.
Emergency Shelter and Non Food Item  ( ES NFI )  Cluster partners have provided temporary structures and shelter kits to health facilities to support isolation spaces and curb COVID 19 transmission. They also leveraged their broad footprint to reach more than half a million people with COVID 19 awareness raising activities.
In response to new multi sectoral needs, in the first half of 2020, Food Security and Agriculture Cluster partners reached 4.1 million people with food and livelihood assistance, including support for 326,648 vulnerable people whose needs have been aggravated by the COVID 19 pandemic.
Working closely with health actors, WASH Cluster partners mobilised to improve availability of water and sanitation facilities and hygiene infrastructure in health facilities and border crossing areas. WASH partners also scaled up pre positioning and distribution of COVID 19 specific WASH supplies across 27 provinces. Collectively, WASH partners have distributed more than 4 million bars of soap, provided hygiene services to more than 1.4 million people, and ensured access to clean water for 528,270 people. WASH partners have also set up more than 2,076 public, community level handwashing stations and 178 handwashing stations at health facilities.
Conflict is also limiting market functioning and access in certain districts, while generally imposed unofficial taxes on traders in contested areas are increasing pressure on food prices.
Conflict and insecurity have continued to severely impact local livelihoods throughout 2020 in Afghanistan and, according to several sources, have likely not decreased in the winter months to the same extent as is typical, likely in part due to above average temperatures and an increase in incidents in urban areas.
The loss of family income and employment directly connects to increased protection risks for girls and boys with children forced to work and young girls, being married early for the dowry which can provide families with the funds needed to survive the economic shock of the pandemic.
With agriculture playing a crucial role for the national economy in Afghanistan, accounting for about a quarter of GDP and the agriculturally dependent population constituting 60 percent of the total population4, the lack of access to sustainable agricultural opportunities is detrimental to survival.
The findings of the recent assessment suggest that people are severely struggling to meet basic household needs.
The children of Afghanistan, especially those already suffering from poverty and inequity, are among the most vulnerable to the harsh socio  economic impact of COVID 19.
WFP market price data showed that almost all main food commodity prices have increased and both purchasing power indicators decreased
With the rise in poverty and hunger, it is sadly predictable that there is a growing chance that children who are out of school will not go back once schools reopen as parents won't be able to afford to send them and many children have started working to support there families.
Findings from the World Vision assessment showed that 88% of respondents require food assistance, confirming the negative consequences of the pandemic.
At the outset of 2020, more than 12 million people were already facing acute food insecurity due to decades of conflict, natural disasters and growing poverty, according to the Integrated Food Security Phase Classification  ( IPC )  Analysis.
Results showed an increase in loans as an alternative source for compensating lost income, while 92% of the population has incurred significant debt.
Since 2015, WVA  ( World Vision Afghanistan )  has continued its intervention in the center through the funding received from World Vision Korea.
Humanitarian partners urge the Government to ensure laboratories are appropriately equipped, staff receive timely renumeration and that procured supplies go to under resourced health centres in a transparent manner so that life saving support can be delivered to those most in need.
Only 221,611 people out of a population of 40.4 million have been tested.
MoPH data shows that as of 14 January, 53,819 people across all 34 provinces in Afghanistan are confirmed to have had COVID 19. Some 45,105 people have recovered, and 2,320 people have died – at least 87 of whom are healthcare workers.
Indeed, securing commercial traffic should be made a top priority by both sides – as reprobate Taliban commanders or even some militias aligned with government forces may turn predatory as their resources begin to dwindle. Meanwhile, the Afghan government can prioritise smoothing the way for international and local relief efforts; Crisis Group spoke to several humanitarians who described confusion and coordination difficulties between NGOs and government authorities early on, which led to delays in program planning as well as the ability of staff to travel and deliver aid.
With lockdowns of urban centres leaving hundreds of thousands of day labourers out of work, and rising food prices prompting panic and desperation, there is potential for increased crime.
Indeed, large populations of migrant workers continue to seek to cross borders in and out of Iran and Pakistan, and closures at borders with limited state capacity will likely lead topopulation build upin makeshift camps; not only could these crossing points serve as hubs for infection, but there are serious human rights and health concerns – even claims of several dozen migrantsbeing drownedby Iranian border guards.
The Afghan health ministryassessedthat the virus has spread to 29 of 34 provinces, first as a result of these mass returns but now organically within communities, too.
The nutrition outlook for the remainder of the year remains bleak. Recent analysis by the Nutrition cluster revealed an increase of 13 per cent in cases of Severe Acute Malnutrition  ( SAM ) . Additionally, a staggering 15.3 per cent of infants under six months are affected by wasting, 6.2 per cent of whom are severely wasted.
In Zabul province, 335 families  ( approximately, 2,345 people )  were displaced to Qalat city due to ongoing fighting in Suray, Shinkay district.
All educational activities have resumed as of 3 October with CBEs and public schools now operating.
According to WFP's market monitoring, the average wheat flour price  ( low price and high price )  increased by 10 per cent between 14 March and 11 November, while the cost of pulses, sugar, cooking oil and rice  ( low quality )  increased by 21 per cent, 18 per cent, 31 per cent, and 20 per cent, respectively, over the same period. This price increase is accompanied by a declining purchasing power of casual labourers and pastoralists – which have deteriorated by over 9 per cent and 14 per cent respectively  ( compared to 14 March ) . These factors, combined with COVID 19 related interruptions to informal employment, are driving people into crippling debt.
Following two months of consistently lower confirmed COVID 19 cases, MoPH tracking data is beginning to reflect anecdotal reports of a recent uptick in cases, with 186 new COVID 19 cases recorded over the past 24 hours and 981 over the past week.
Afghanistan has a test positivity rate – positive tests as a percentage of total tests – of more than 33 per cent, suggesting overall under testing of potential cases.
Malnutrition is on the rise and is putting people at increased risk to COVID 19.
Schools and CBEs need appropriate preventive measures in place to reduce the risk of COVID 19 transmission and provide safe learning spaces. This is challenging for many schools and CBEs that lack adequate WASH facilities.
Children who had their education disrupted by the COVID 19 outbreak, and particularly children who had no access to alternative learning modalities during the pandemic, are in urgent need of assistance.
Increased insecurity due to an uptick in violence is causing more displacement and limited livelihood opportunities for conflict affected IDPs, particularly in peri urban or urban environments.
Overall prices for key commodities remain above the pre COVID 19 price baseline with the cost of some items such as vegetable oil continuing to affect the purchasing power of poorer households.
As a result of the COVID 19 outbreak families are facing higher levels of debt, reduced income levels and increased household expenditure pressures due to rising commodity prices.
7,729 people across 9 provinces received Child Protection community based awareness raising on the protection of children and positive coping mechanisms during the COVID 19 pandemic, bringing the total to 276,308 people reached since the start of the crisis.
During the reporting period, 420 persons with specific needs  ( PSNs )  received cash assistance across 10 provinces to help them cope with the financial impact of COVID 19. Since the start of the crisis, 3,012 people have received this kind of cash assistance.
The current situation highlights the need for further PSS services, information  sharing on how IDPs can adapt to isolation according to their context, and information on other relevant measures in case of COVID 19 infection.
Based on the protection monitoring reports, the COVID 19 pandemic has exacerbated stress, stigma, and fear of death within the IDP settlements in Hirat province. The lack of sufficient space to allow for individuals exhibiting COVID 19 like symptoms to isolate was also reported as a concern.
A needs assessment is ongoing for a reported 2,390 people displaced by conflict in Kabul and Paktya provinces.
In Hilmand, movement in affected areas is restricted due the presence of IEDs. On 2 November, a roadside IED in Bolan, Lashkargah reportedly killed seven people and wounded two others. The main roads connecting Kandahar city to Panjwayi and Zheray are only partially open due to damaged culverts and the threat of IEDs. The presence of IEDs has also been reported on farms in Arghandab district. Three health facilities in Hilmand remain closed while nine others are partially open. Five Mobile Health Teams suspended their services in Maywand and Zheray districts affecting 20,000 people in hard to reach areas.
All main roads to Dehrawud and Gizab are closed with people using alternate roads. On 4 November, the health facility in Gizab was closed due to ongoing fighting depriving 30,000 people of access to health services. Humanitarian activities have been suspended due to active fighting in Dehrawud and Gizab District Administrative Center, Uruzgan.
11% of households do not have a functional health facility within 2 hours of their house
According to the 2020 Whole of Afghanistan Multi Sector Needs Assessment, 70 per cent of displaced households reported limited access to soap due to high prices. At the same time, 45 per cent of displaced households reported lack of access to water for handwashing.
40 per cent of the consulted IDPs, 45 per cent of returnees and 27 per cent of host community members reported an increased time required to procure water.
[ COVID 19 ]  Recently developed rapid diagnostic tests  ( RDT )  need to be integrated into current testing plans.
An estimated 16.9 million people are in crisis or emergency food insecurity from November to March, 5.5 million of whom are in ‘emergency' level food insecurity  ( IPC 4 ) .
The socio economic impacts of COVID 19 are translating into a dramatic impact on food insecurity with levels now similar to those seen during the 2018 drought.
Moreover, the national capacity for COVID 19 testing has topped 5,500 a day, but according to WHO, lack of demand means that fewer than 400 tests are actually being conducted daily.
In support of the Government, humanitarian partners have provided hundreds of thousands of pieces of PPE and several thousand items of life saving medical equipment to the Ministry of Public Health.
Public health experts strongly urge the public to follow advice on physical distancing, mask wearing, good hygiene, hand washing and other proven strategies that mitigate the risk of COVID 19 transmission amid this second wave.
As Afghanistan's displacement crisis enters its fifth decade, UNHCR is calling for targeted investments, both inside Afghanistan, and in Iran and Pakistan, which between them are hosting over 2.3 million Afghan refugees.
The Cash for Shelter project, which was piloted with 600 vulnerable displaced and returnee households starting last year, provides families with a US$3,300 cash grant and technical assistance to construct a two room shelter that includes a bathroom. The cash is provided in three installments as building progresses.
Mohammad's experience is all too common in Afghanistan, where more than 440,000 people were internally displaced by conflict in 2019 alone, in addition to hundreds of thousands driven from their homes by natural disasters.
215,020 people received humanitarian assistance in 2020 as of 27 December.
During the same timeframe, thousands returned from neighboring Pakistan, and until March, the deportation of Afghans from Turkey and several European Union countries continued. Currently, deportations from Iran continue.
In Surkh Dewall, a third of residents report food shortages, with women headed households being most vulnerable.
As on 13 April 2020, 665/4314 tests have reported positive with major hotspots being in Kabul  ( 145 )  and Herat  ( 280 ) .
In 2019 and 2020, the ERM reached 400,000 people in all provinces through the delivery of cash grants, clean water, and access to sanitation services.
The conflict continues to limit people's access to services and lifesaving assistance, with the closure of some healthcare and educational facilities, as well as limited safe access for aid workers outside of urban centres.
We are facing the very real risk that children could die from starvation.
In Uruzgan, 2,811 IDPs have been identified as having humanitarian needs as of 11 November, with assessments ongoing.
In Kandahar, humanitarian partners have been deployed to Dand and Kandahar districts to assess IDP needs.
The Afghanistan National Disaster Management Authority  ( ANDMA )  in Hilmand has provided cash assistance to 674 IDP households, with each household receiving AFN 5,000.
According to initial reports, IDPs residing in Arghandab district and other parts of Kandahar city have begun returning to their place of origin.
IDPs received food, NFIs, WASH items and multi purpose cash with accompanying COVID 19 prevention support. IDPs also received water through water tankering.
As of 11 November, humanitarian partners in Hilmand have provided assistance to all 13,970 verified IDPs.
The suspension of humanitarian activities in the district will leave people unable to access WASH, protection and shelter support, or receive key COVID 19 prevention messages that promote virus mitigation measures.
The five Mobile Health Teams  ( MHTs )  in Maywand and Zharey districts remains temporarily suspended, depriving some 20,000 people of essential health services.
Communities have also self reported the closure of several health facilities.
The closure of health clinics due to insecurity is directly affecting more than 87,000 people, with thousands more indirectly affected by limited services at health facilities that are only partially open.
Three health facilities remain closed, while ten others are reportedly partially open, although this is to be confirmed.
Some 13,970 IDPs have so far been verified as being in need of humanitarian assistance.
Telephone lines remain down in the affected districts.
Sporadic armed clashes are still ongoing in Dehrawud and Gizab districts.
The maternal mortality rate in Hilmand, Nangarhar and Faryab exceeds the already high national average. The unavailability of emergency obstetric care, in conjunction with lack of qualified female healthcare workers, has compounded the situation.
Military operations and airstrikes are ongoing in the north and the southwest of Kandahar with a focus on Maywand, Zharey and Panjwaiy districts.
Phone networks have been partially restored, albeit with limited coverage and this is still challenging the smooth flow of information.
People continue to use alternate routes in NSAG  [ Non State Armed Groups ]  controlled areas to avoid IEDs  [ Improvised Explosive Devices ] .
Fighting that started on 11 October between the Afghan National Security Forces  ( ANSF )  and a non state armed group  ( NSAG )  continues in Nawa e Barakziay and Nahr e Saraj districts.
Under funding in 2020  ( 39% as of 30 Sep ) , however, has limited the depth of assistance provided, forcing greater focus on higher reach, lower cost response activities, predominantly related to the pandemic.
This challenging situation has been exacerbated by the economic impacts of COVID 19 as movement restrictions, transportation blockages, market shortages, and price rises have been reducing already very limited employment opportunities.
Johanniter with its own resources started its response in Kabul Informal Settlements; Ghulam Camp for refugees/externally displaced persons from North Waziristan and Kuchis in Khost province and at the entry points of Kunduz, Chardara, Aliabad, Khanabad and Imam Sahib.
WFP and UNICEF also provide technical support and ad hoc training to support wasting treatment and the World Health Organization  ( WHO )  provides support for in patient care, including the training of health staff on the management of severe acute malnutrition, the supply of therapeutic milk prepa  ration kits, medical equipment and medicine and the rehabilitation of water and sanitation systems of in patient units in hospitals.
Most recently, the COVID 19 pandemic has led to rises in food prices, the closure of borders with neighbouring countries, reduction in mobility, loss of jobs and disruption of routine health services, leading to a fall in in patient admissions of 50% in spite of prevalent COVID 19 in the population.
Heavy rain caused damage to one vehicle, 11 houses, main road, 300 meters of citation wall, 130 meters of water canal and destroyed 50 acres of agricultural land
Since in Afghanistan GBV is mostly targeting the major vulnerable group of Afghan population i.e. Afghan women and girls, therefore, women right activists, women empowerment civil society organizations and media through TV and radio awareness programs can contribute in dissemination of key advocacy messages, and specifically where Afghan women and girls can re  ceive GBV services.
The main safety and security concerns affecting women include access to livelihood including being prevented from working by families, health and hygiene issues due to limited access to water, hygiene promotion activities and hygiene materials .
Medical concerns, child labour, fighting with each other and child marriage are recorded as the four top child protection concerns.
Child Labour remains rampant as a negative copying mechanisms due to the limited access to livelihoods opportunities for IDPs
Access to the civil documentation for IDPs within the IDP settlements continues to present a huge gap in service delivery. This has in turn affected access to education services for children and job opportunities.
In order to effectively mitigate the impacts of GBV on the most vulnerable majority of Afghan population i.e. Afghan women and girls, IDPs and minorities, it is important to beyond the response phase of COVID 19 pandemic and consider longer term recovery phase as well.
In the Southwest region, psychological abuse are most prominent, constituting 45% of the GBV cases in the region.
In the Western region, psychological abuse is most prominent, constituting 49% of the GBV cases in the region.
In the Eastern region, physical abuse is most prominent, constituting 38% of the GBV cases in the region.
In the Central region, physical abuse is most prominent, constituting 38% of the GBV cases in the region.
In the Northeast region, the psychological abuse is most prominent, constituting 39% of the GBV cases in the region.
In March 2020, physically disabled, lactating women and elderly are the main top vulnerabilities among the IDP populations followed by elderly supporting households, pregnant ladies and female headed household.
The prevalence of debt and borrowing money have increased in March in comparison the January and February, this is attributed to the increased cost of living and the loss of livelihood due to COVID 19 restrictions.
Debt, theft and drug addiction remained the top concerns in regards to the safety and security of the IDPs during March 2020.
The GBV data indicates that in total forced marriage cases, 31% of the cases are in western region of Afghanistan. These areas are hit hardest with COVID 19 as they are bordering with Iran, where an influx of refugees and returnees were crossing the porous border without being tested for COVID 19.
In Afghanistan, instances of GBV are rising in silence.
While COVID 19 is still persistent, in the 13   18 June 2020 in 22 provinces, there were around 400 cases of GBV. The data shows that the most common violence experienced by Afghan women and girls is psychological abuse which constitutes 39% of the cases reported last week.
There was an increase in the numbers reporting vulnerabilities related to physical disability in March compared to Jan and Feb 2020.
The overcrowding and under staffing coupled with underequipped hospitals are a persisting barrier in health provision to GBV survivors.
During the response stage of COVID 19 attention is turned to containing and controlling the spread of the virus which has weakened the ground for promotion and protection of women's rights, given the varying levels of quarantine and lockdowns throughout the country which have impacted mobility and access.