nlp-thedeep/humsetbias huggingface dataset:
ES NFI  [ Emergency Shelter and Non Food Items ]  assessments show that people with COVID 19 symptoms are unable to self isolate due to overcrowded conditions
As a result of a more comprehensive response approach to escalating needs due to COVID 19, the WASH Cluster's requirements is now $152.2 million, up from $70.9 million in the original 2020 Humanitarian Response Plan.
A few WASH Cluster partners report slower implementation of response activities as a result of COVID 19 lockdown measures and movement restrictions.
Between 6 and 12 July, 92 handwashing stations have been set up at the community level in Kabul Informal Settlement. A total of 2,168 handwashing stations have been set up at the community level in 21 districts across 11 provinces since the start of the crisis.
Continuation of all health services – including the availability of primary care for vulnerable people and community engagement to combat misinformation – is critical.
49,893 women received antenatal and postnatal care from midwives deployed through Mobile Health Teams  ( MHTs ) .
During the first two years of this multi year plan, emergency shelter assistance was provided to displaced people within an initial period of up to three months and was predominantly oriented towards items such as tents and basic household items. While such support has been vital to saving lives, to date it has not created opportunities for recovery or facilitated displaced people's reintegration and return.
Education partners will work closely with the WASH and ES NFI  [ Emergency Shelter and Non Food Items ]  partners to ensure schools and Community Based Education  ( CBE )  learning spaces are safe to re open with appropriate hygiene facilities and adequate winterisation.
Education partners will continue to invest in the resilience of the education system by supporting the recruitment, training and deployment of teachers, particularly women. The inadequate number of female teachers has had a direct impact on girls' ability to benefit from schooling. Training of School Management Shuras on the importance of education, especially for girls, is another example of the EiEWG's  [ Education in Emergencies Working Group ]  contribution to community resilience building.
Regarding the information gap/little observance to covid 19 preventive measures upon arrival in Afghanistan, mostly observed at Spin Boldak and Torkham, this was due to limited opening of the borders for pedestrian movements  ( until late September 2020 ) , which created an overcrowded situation as thousands of people tried to cross at once therefore, reducing attention to services provided by partners, including health screening and information dissemination about COVID 19.
MoPH in Afghanistan, through social media, advised Afghans not to travel to other countries to avoid the spread of COVID 19.
Pro Government Forces were responsible for 32 per cent of all civilian casualties during the first quarter of 2020, causing 412 civilian casualties  ( 198 killed and 214 injured ) . Of concern, Pro Government Forces were responsible for more child casualties than Anti Government Elements during the first three months of the year and over twice as many child deaths7, mainly due to airstrikes and indirect fire during ground engagements
Similarly, 30% of women and 25% of men health workers are experiencing very high degree of stress in Kunduz. 100% of women health workers in Helmand are experience moderate to high degree of stress.
Almost every province has moderate and higher degree of stress recorded among the health workers, but Kunduz Nangahar and Kabul are among the higher among the responders related to degree of stress.
Feeling stressed, sad, confused, scared or angry during is an experience that staff are likely going through; in fact, it is quite normal to be feeling this way in the current situation.
Powered air purification respirator  ( PAPR )  is more used by COVID responding health staff  ( 53% ) , whereas overall it is 33% only
When asked about N95 masks, the responses are that, they are not available in all the markets, they are expensive and thus out of reach for common people and finally it is good to use when someone is infected rather than everyone.
Following the COVID 19 outbreak, IOM reports that the flow of spontaneous returnees  ( citizens of Afghanistan )  from Iran increased compared to previous months, primarily due to concerns about the spread of COVID 19 in Iran.
Humanitarian partners began distributing food and household items on 4 April in Behsud 1 and Behsud 2, Maidan Wardak province. During the reporting period, 5,376 people received humanitarian assistance in Paktya and Logar provinces.
While WASH partners plan to scale up assistance, ensuring adequate assistance in hard to reach districts is expected to continue to be challenging. Ensuring early funding to mount a logistics heavy and early response will be critical.
IOM provided post arrival humanitarian assistance to 1,008 people or 7 per cent of all undocumented Afghanistan nationals returning from Iran at its transit centres in Hirat and Nimroz during the past week.
The burden of other diseases also remains high while care seeking behaviour has reduced.
The pandemic poses a threat to many years of effort to get more girls enrolled in school or going to university.
As a result of the severe drought in 2018 and dented business and investor confidence, the economy only grew by an estimated 1.8 per cent in 2018.
The country remains highly susceptible to the risk of earthquakes with potentially catastrophic consequences if a major quake occurred near a major population centre.
Recent IDPs and returnee households are more likely to report not having a heating device  ( 78 per cent and 71 per cent, respectively ) .
19,070 women and 8,230 nutritionally at risk children under the age of 5 years received blanket supplementary feeding.
In September, WFP reached 1,114,805 food  insecure girls, boys, women and men across 32 of Afghanistan's 34 provinces.
Unemployment continues to be a major driving force for economic vulnerability in Afghanistan and a small proportion of households have access to productive or sustainable remunerative employment
As the capital and centre with more employment opportunities and fewer sources of conflict, Kabul is a major hub for the displaced populations.
Only 45% of households reported access to land. Among them, around 50% cultivated less than 1 acre.
Inform and train teachers and students on COVID 19 and prevention measures.
“Despite lack of data in Afghanistan, emerging evidence shows that, with the COVID 19 crisis, the number of women and girls experiencing violence, more particularly domestic violence, has increased in all provinces of Afghanistan'  ( Gender Alert on Covid 19 in Afghanistan, May 2020 )
Children throughout Afghanistan continue to face pervasive violence and a range of protection risks.
Distribution of hygiene items including MHM.
In 2019, the WOA Assessment found IDP households to be, on average, significantly more indebted than they were in 2018, with households in drought affected regions the worst affected.
On top of that, there are approx. 2.6 million internally displaced persons, the number having increased by 426,000 in 2019 alone.
Markets are not functioning adequately and there has been a reduction in provision of humanitarian assistance.
35.3% of children who were previously enrolled in formal education  ( n=68 )  said that the COVID  19 outbreak has been very stressful on their usual school experience
In the SFSA 2019, 63 per cent of people reported that they experienced shocks including reduced income  ( 25 per cent ) , loss of employment  ( 29 per cent ) , natural disaster  ( 12 per cent )  and huge increases in food prices  ( 9 per cent ) . These shocks have gradually eroded rural livelihoods and pushed more than one fifth of the population to resort to negative emergency coping strategies.
In Afghanistan, MoPH data shows that 665 people across 27 provinces are now confirmed to have COVID 19 with 38 recoveries and 22 fatalities.
Among the categories of respondents, 44% of them are Internally Displaced Persons, 55% are from the host families and 1% is externally displaced persons  ( refugees from Pakistan Waziris in Khost ) .
For many Afghan women, security of tenure is only achieved through their relationship with men – their fathers, husbands, brothers or sons. Inheritance and dowry  ( mahr )  represent two of the main opportunities for women to acquire ownership of land and housing and achieve security of tenure. At the end of their relationships with men  ( through either death or divorce )  women become vulnerable to losing their possessions and security against the competing interests of dominant family members.
WOA Assessment Focus Group Discussion participants discussed borrowing money or taking loans from relatives, family members, neighbours or banks to help them cope with conflict and displacement. Some participants noted that they have to pay their debts back with unsustainable interest rates due to a high demand in the community for borrowed money, pushing people further into poverty. The debt situation is extreme among returnees in Badghis according to both the WoA Assessment and DTM monitoring.
However, there were some provinces in which it was particularly common for shock affected households to face a multitude of needs at the same time, including Uruzgan in the south and Takhar in the north east. Both provinces have been heavily affected by conflict and displacement, overloading existing basic services and limiting the humanitarian space for a comprehensive response.
IDP HHs are sheltering in self made tents with no heating facilities.
The virus has also reshaped the humanitarian operating environment in Afghanistan demanding a deeper and wider response from aid agencies using flexible new approaches to expand reach and ensure life saving support to pre existing needs is not interrupted.
While girls' access to education may be limited by cultural expectations; these are, in many cases, also tied to perceived and real security risks, as well as the appropriateness of the school curriculum and physical set up to local cultural norms.
Families often live in conditions that lack of dignity, privacy, safety and security. These concerns disproportionately affect persons with specific needs: women, girls, children, people with disabilities and the elderly. Those who are socio economically vulnerable, including households head by a single female with a low income to dependency ratio, are more prone to sub standard living conditions.
In 2019, almost 300,000 people were affected by a typically severe floods in 24 provinces, including many that are not usually affected by flooding at all. Some of those affected, especially in rural areas, continue to have emergency food and livelihoods needs to maintain their well being and support recovery from this state of acute vulnerability.
Annually, about a quarter of a million children under five and lactating women including IDPs, returnees and shock affected people face increased risk of acute malnutrition and hence require comprehensive nutrition services to mitigate the chance of a deterioration in their nutritional status.
Such is the violence and hardship facing many households in conflict affected parts of Afghanistan, that displacement remains a constant feature of the crisis. Repeated displacement is common as the conflict moves around the country, affecting people firstly in their place of origin and then in their initial place of displacement. People who have been displaced multiple times are acutely vulnerable due to their increasingly depleted financial and emotional reserves, with higher proportions of households in debt and with members facing mental health issues.
For the remainder of 2020, all clusters have planned to reach refugees with a multi sector response.
Each organisation defined a precise spatial area within which to deliver integrated assistance that seeks to address the humanitarian and protection problems specific to each area. Planning processes and responses place a significant emphasis on community and wider stakeholder engagement and are designed to be inherently integrated across sectors in order to address needs holistically.
Efforts to reach more women and girls by increasing the number of female frontline workers – such as in healthcare delivery or protection from sexual and gender based violence  ( SGBV )  – are also being actively pursued.
Imports declined by 14 percent  ( US$ 256 million )  in the first quarter of 2020. Lower imports reflected lower economy wide demand, in the context of political uncertainty and the onset of the COVID 19 crisis.
Some 165,000 internally displaced children, including those in displacement sites, as well as 122,220 returnee children from Iran and Pakistan will require EiE services in 2021.
Since the first case in February, the central government has been working to stabilize market prices by protecting food supply into the country and reopening borders for supplies.
A comprehensive social protection system remains critical but elusive in the current economic climate.
In the absence of something more comprehensive, approximately 35 million people will need an emergency social safety net in 2020 as a result of COVID 19 and its economic consequences.
Afghanistan's fragile health system is thinly spread across the country due to ongoing insecurity and infrastructure challenges.
Strengthen communication with communities to avoid rumours and creating panic.
This year, Germany has already made more than 17 million euro available for this and other humanitarian assistance projects in Afghanistan.
Support training of non medical staff on IPC and personal hygiene in coordination with health workers
Increase age adapted handwashing facilities, one for each classroom with provision of soap.
The electoral management bodies continued activities despite limitations owing to COVID 19.
Lockdowns instituted to limit the exposure of residents to COVID 19 continue throughout the country, resulting in closures of these main cities.
Fear of potential violence has also meant that children are pre emptively kept from school.
Agricultural infrastructure were also impacted.
Children comprise almost eight out of every 10 civilian casualties from explosive remnants of war.
Support material provision for cleaning and disinfection of facilities.
Installation of handwashing facilities and provision of soap and water.
Humanitarian actors continue to advocate for and provide assistance to facilitate their access to education in public schools and health services, and the most vulnerable among this group receive financial assistance to meet their basic needs.
Ensure provisions of WASH services  ( water and sanitation facilities construction ) .
The security situation remained unstable with reports of continued fighting and military operations in Hirat, Farah and Ghor provinces.
Marred by decades of conflict, Afghanistan faces a protracted protection crisis characterised by a high rate of civilian casualties; widespread risk of explosive hazards, grave physical and psychological trauma, targeted attacks against schools and health facilities, high prevalence of gender based violence, and limited access to secure land tenure and documentation. The overall protection environment is also compounded by an underlying inequality between various population groups in the country – with women and girls, most often at the bottom of societal structures.
The Nutrition Cluster therefore anticipates 3.43 million children, boys, girls and women will require emergency nutrition services in 2021.
Continued displacement and poor WASH conditions contribute to disease outbreaks, especially diarrhea, that spread at a rapid pace. The immune response of children affected by acute malnutrition is highly compromised, increasing their risk of dying when affected by these outbreaks.
The financial struggle of these households also manifests in increased risks for children. Households headed by a person with disability reported a higher proportion of children  ( 11 17 years )  working outside the house  ( 24 per cent compared to 19 per cent for other households ) . Twenty four per cent of these households reported that children having to earn money was a factor in their boys not attending school, compared to 19 per cent for other households.
Ongoing conflict continues to drive humanitarian needs across Afghanistan, inflicting high levels of civilian casualties, triggering displacement, causing collateral damage to health and education facilities, as well as disrupting and destroying other life sustaining civilian infrastructure such as water, electricity and telecommunication systems.
However there has not been a commensurate investment in post operative physical rehabilitation, leaving many survivors to struggle with severe disabilities and without prosthetics.
Social and cultural norms limit the role of women outside the home and reduce their access to services. The high numbers of men killed in combat or as a result of violence over the past four decades have disrupted traditional family units, forcing women, the elderly and sometimes children to take the role of leader and breadwinner in their households.
The WOA Assessment found a strong link between being in debt and having to rely on negative coping strategies. Ninety five per cent of displaced households with a severe or extreme livelihoods coping strategy index  ( LCSI )  score reported being in debt, compared to 61 per cent of those with a low  ( minimal or stress )  LCSI score.
The devastating drought drove a large proportion of humanitarian needs in 2019 particularly in terms of displacement and food insecurity. Heading into 2020, the drought emergency has itself passed, however its impacts continue to linger, as millions of rural families struggle to recover from the stress, debts and loss of assets they have incurred.
In a bid to contain the spread of the virus, the government introduced social distancing measures in major cities from mid March. Restrictions were eased following the Eid holidays, despite an increasing number of daily cases.
Incidents of aid diversion continue to be reported against parties to the conflict through the Awaaz call centre and other accountability mechanisms.
Tuberculosis remains rampant with some 72,000 cases, three per cent higher compared to 2019.
Health achievements as of 31 August 2020: 40 women trained in midwifery
In Afghanistan, chronic vulnerability and under nutrition significantly overlap. People's eroded resilience capacities make them susceptible to sliding down into acute malnutrition status, irrespective of the degree/scale of severity of the shock. This reduced coping capacity has been compounded by years of repeated shock.
53% of respondents report fever as a sympton of COVID 19 in their household
Fighting creates both an immediate and long lasting burden for civilians, exposing them to sudden and terrifying violence and leaving them vulnerable to unexploded ordnance, both of which generate significant trauma related needs. Over the first nine months of 2019, nearly 73,000 trauma cases were recorded, a 28 per cent increase from the same period in 2018. Fatalities among these trauma cases were unusually high  ( 18 per cent )  compared to recent years, underscoring the increasing deadliness of the conflict. Some 47 per cent of the trauma patients seen in 2019 were left with a permanent disability.
Decline in agriculture activity due to movement restrictions and also lack of demand due to unemployment worsened socio economic condition of most which ultimately affected well being of children.
Organisations should support care givers with positive parenting strategies in order to create a safe and supportive environment and reduce incidence of violence against children.
Since COVID 19, loan levels have increased by 6%
Rapid population growth, rural urban migration and continued displacement are further compounding the stress on urban centres, increasing competition for local resources and basic services.
Population movement is placing enormous pressure on hosts through overcrowding and competition for access to limited resources and livelihoods. Many in protracted displacement are living under the constant threat of eviction because they do not have secure land tenure. Sixty per cent of IDP households displaced for more than six months reported not having secure tenure.58 IDP families residing in informal settlements report that they earn on average 32 per cent less than other IDP households, more frequently do not have Tazkeras  ( national ID cards )  and have children who are less likely to attend school.
Badakhshan, Badghis, Farah, Faryab, Ghazni, Kunduz, Laghman and Nangarhar are the main provinces of origin and displacement for conflict affected communities. In addition to civilian deaths and displacement, the conflict has had grave consequences for the physical status of millions of people across Afghanistan. Some 11 per cent of people in Afghanistan are estimated to have at least one form of physical disability, many caused by the conflict.
The combined use of suicide and non suicide improvised explosive devices  ( IEDs )  is the leading cause of civilian casualties  ( 42 per cent ) , followed by ground engagements  ( 29 per cent )  and then by aerial attacks  ( 11 per cent ) . Aerial attacks continue to be the leading cause of civilian deaths  ( accounting for some 23 per cent ) .
Strategic Recommendation 1: Guarantee access and promote conditions of peace in conflict affected hotspots.
Vulnerability and priority needs: 67% Exhibiting health seeking behaviour
Some 397 people have recovered and 90 people have died. Eight healthcare workers are among those who have died from COVID 19.
Civilian casualties attributed to the ANSF for April 2020 numbered 172 civilians, an increase of 38 per cent compared to April 2019 and 37 per cent higher than March 2020.
In Paktya, IDPs reported that following their displacement, their land in their AOO has since been damaged and properties occupied by armed group members and supporters of NSAG TB, and expressed worry that they will be unable to return to their AOO as a result.
Owing to decades of conflict, deep social trauma, double digit unemployment, acute poverty, and inadequate access or lack of access to mental health services, Afghanistan bears a high burden of mental disorders amongst its people.
30% of households reported using an unimproved water source as their main source for domestic use at the time of the interview:
AWD affects more than 37 per cent of displaced households with children under the age of 5.99 Measles and the Crimean Congo Hemorrhagic Fever  ( CCHF )  outbreaks also persist across a majority of provinces.
The Cluster has identified food and livelihoods needs for various vulnerable groups in 2020 and estimates that 8.2 million people will require immediate food and livelihood assistance across the country.
The winter season is critical for successful agriculture and food production throughout the year. According to the 2019 SFSA, 42 per cent of farmers have no seeds and another 40 per cent reported insufficient seeds for the winter planting window.
Livelihoods needs are very high across Afghanistan. DTM data, the SFSA and other datasets all show that a lack of access to livelihood opportunities/cash income is among people's top three priority needs. Twenty nine per cent of respondents in the 2019 SFSA listed loss of employment as a major shock. This pushes people to resort to negative coping mechanisms such as going into debt, sending children to work instead of school, and selling household assets.
Some 3.9 million people were reached with food security support in the first nine months of 2019.
IDPs displaced by conflict show a higher level of humanitarian needs as they have either depleted their assets or cannot access them. The WOA Assessment reveals that 31 per cent of households displaced by conflict have either severe or moderate hunger.
Families displaced due to continued conflict, as well as returnees and refugees from Iran and Pakistan, also present an added strain to the food security situation across the country.
Waterproof long sleeve gowns are highly used by COVID 19 responders  ( 69% )  compared to overall 33%
Some 63 per cent of those surveyed under the SFSA have experienced shocks – 25 per cent experienced reduced income; 29 per cent suffered loss of employment; 10 per cent were affected by natural disasters; and some 8 per cent were challenged by increase in food prices. These shocks – in time – have pushed almost half of the population to resort to negative  ( emergency & crisis )  emergency coping strategies.
% of sites in which KIs reported the majority of households occupy inadequate shelter, by region: Capital 40%
Loss of livelihoods has led families to use negative coping mechanisms, such as removing children from school or marrying them off early  ( in the case of girls ) , depriving them of essential learning and exposing them to additional protection risks.
The 2019 WOA Assessment shows that at least 21 per cent of households with at least one child not attending school reported withdrawing children from school in order to bring in extra income. The WOA Assessment data also indicates that more than half  ( 52 per cent )  of children in hard to reach areas need education in emergency support.
Where there is a high concentration of IDPs or returnees, schools have been left overloaded and unable to cope with the influx of children received. Many returnee children are unable to enroll in schools due to insufficient or inappropriate documentation, while others are forced to enter in the wrong grade or be taught via an entirely unfamiliar curriculum or language. The upshot is that a generation of children is at risk of missing out on essential education in their most formative years with grave consequences for their development and later prosperity.
Conflict continues to deprive Afghan children of an education in situations where their schools are occupied or damaged during fighting; when parents withdraw their children due to insecurity; or because of overcrowding in instances of IDP and returnee influxes. In the first 10 months of 2019, 722 schools were forcibly closed and remained closed due to insecurity, affecting around 328,094  ( 113,597 girls and 214,497 boys )  children.
Due to limited public health resources and testing capacity, testing criteria, lack of people coming forward for testing, as well as the absence of a national death register, confirmed cases of and deaths from COVID 19 are likely to be under reported overall in Afghanistan.
The Polio National Immunization Days  ( NIDs )  campaign from 26 to 30 October in all five provinces in the north provided OPV  ( Oral Polio Vaccine )  for 782,560 children under five.
A total of 310,755 people across the country have been sensitised on COVID 19 preventive measures by Nutrition Cluster partners since the start of the COVID 19 crisis.
Preventative measures are needed to protect vulnerable individuals from such negative coping strategies. Partners also raise the need for the establishment of safe houses in all provinces to provide secure spaces and enhanced follow up for GBV survivors.
Based on an assessment conducted by a protection partner in Hirat province, forced marriage and child marriage have become increasingly common practices among poor families to make ends meet.
Almost four out of every 10 children under five years of age in Afghanistan  ( 37% )  are stunted and one in ten children  ( 9.5% )  are wasted.
As of 11 November, five humanitarian partners' activities in Zharey, Panjwaiy, Mawyand and Arghandab districts remain suspended.
Annual trends of IDP arrivals   2020: 461,177
Since it signed its agreement with the United States, the Taliban appears to be adhering to its commitment to reduce violence against international military forces, which have begun to withdraw from Afghanistan, she said. However, recent weeks have seen a resurgence of conflict related violence, driven mainly by Taliban attacks against the Afghan National Defence and Security Forces. For March alone, she added, UNAMA has recorded more than 180 civilians killed, with the Taliban responsible for a high number of civilian casualties.
Overall annual trends of out migrants to Iran   2020: 74,295
The findings indicate a significant minority  ( 29% in Faryab )  did not have access to information about COVID 19 two months into the pandemic.
The UN urges all parties to stop the war of words that is not helping those Afghans working to have intra Afghan negotiations commence at the earliest time. In recent weeks the accusatory nature and bellicose tone of statements from all sides have played a negative and unhelpful role.
On average, it takes people in rural areas three times longer to collect water.
The impact takes place in different districts of Logar province where 80 houses and more than 100 acre agricultural land are reported damaged.
Children in Afghanistan are exposed to extreme harm as a result of the ongoing conflict, including killing and maiming from explosive remnants of war, improvised explosive devices and airstrikes.
The Provincial Government will require continued support from humanitarian and development actors, including UNHCR, to address the needs of these people.
Pervasive disregard for International Humanitarian Law  ( IHL )  by all parties to the conflict continues to characterise the conduct of hostilities in Afghanistan and the landscape in which humanitarians are attempting to reach people in need.
The stated unwillingness of the Taliban to agree to a ceasefire at this early stage of the peace talks, the accelerated withdraw of international military forces, the transition of Afghanistan Local Police  ( ALP )  forces, and unclear intentions of other NSAGs  ( primarily ISK ) , indicate a strong potential for deterioration of an already highly dynamic security situation during 2021.
Vital regional remittance rates have shrunk by 40 per cent compared to 2019, new investment remains constrained by political uncertainties and rising insecurity, and both per capita and real GDP are expected to remain below pre COVID 19 forecasts over the medium term.
Wider prevalence and the increased scale of debt is continuing to perpetuate adoption of negative coping mechanisms, eroding household resilience and overall coping capacity, straining the social fabric of the country.
Almost one in five displaced households were found to have taken on catastrophic levels of debt, mainly to cover immediate food, healthcare and shelter related needs.
Social, health and economic impacts from the COVID 19 pandemic continue to be felt across all demographic groups and are undermining the coping capacity of an already vulnerable population. The dramatic contraction in the country's burgeoning economy, loss of informal livelihoods and the high prevalence and depth of household debt are pushing all population groups to adopt dangerous coping strategies which are particularly putting women and children at increased risk.
Violence continues to be a daily, terrifying risk for civilians across the country and is a significant barrier to the rollout of national programmes by the Government, given NSAGs control over so much geographical area.
During the reporting period, FSAC partners supported 965 COVID 19 affected households with cash for food assistance in Kabul city and Nuristan and Nangarhar provinces.
Rising prices for key commodities and loss of jobs in the informal economy due to COVID 19 are leaving many families, especially in urban areas, in crisis and increasing debt.
Limited availability of personal protective equipment  ( PPE )  for frontline staff due to global shortages has presented an ongoing challenge to those providing and receiving assistance.
To date, about half of the funds needed have been committed by donors and the Government  ( $71.8m ) , leaving a gap of $65.8m.
There is also grave concern about levels of violence in the first half of May, including recent attacks claimed by Islamic State Khorasan Province  ( ISKP ) .
The information gap in Spin Boldak has slightly increased since the re opening of the border  ( 21 August )  due to increased population movement to/from Afghanistan. This gap is, again, related to the overcrowded situation and the fact that returnees are not focused on services, including awareness raising about COVID 19.
In general, the information gap was mainly the result of the limited opening of the border for pedestrian movements, which created an overcrowded situation as thousands of people tried to cross at once. Such a situation led to reduced attention to services provided by partners, including health screening and information dissemination about COVID 19.
To address the effects of COVID 19, which created new needs and exacerbated existing ones, the ES NFI Cluster expanded its rental support to help vulnerable people cover rent, utilities, and other housing related needs and prevent possible evictions. The Cluster has also pre positioned tents and other temporary shelters to be utilised either at household level for individual isolation or in support of the health response. The Cluster also expanded its transitional shelter support, by providing extensions, partitioned, or upgraded living spaces to reduce density and increase available covered living areas.
In addition, forty years of protracted conflict have left the country with a fragile health infrastructure – there are less than 2000 isolation beds nationwide – that may exacerbate the human toll of the disease  [ 2 ] .
Returnees and vulnerable households report inability to pay rent due to income loss associated with COVID 19 movement restrictions. They now require cash for rent assistance, particularly in Kabul, Jalalabad and the north east.
Since 1 April, in addition to the unclaimed attack on a hospital in Kabul last week, UNAMA has documented the abduction of 15 healthcare workers by the Taliban as well as a threat to healthcare workers and confiscation of medical supplies by the ANSF.
The health response to COVID 19, led by the Government and delivered through existing health systems and infrastructure, saw substantial investments in system strengthening to improve capacity to respond to the pandemic.
1,235  ( 232 men and 1,003 women )  trained on safe school protocols
The findings of the assessment and consultations were concerning with both results highlighting that people are severely struggling to meet basic household needs.
FSAC partners report access impediments caused by NSAGs, including interference and temporary detention of humanitarian workers, creating additional delays to distributions as partners are forced to conduct individual negotiations on a case by case basis.
The consequences of GBV can be fatal  ( homicide, suicide, self immolation ) ; or non fatal  ( chronic pain, traumatic injury, or traumatic obstetric fistula ) . Family separation has a huge impact on the lives of women. Men often leave their families to seek livelihoods opportunities in urban areas, in addition to undertaking irregular migration to Iran, which is exposing them to potential violence, detention and deportation. Women are left as single headed households  ( eight per cent of all shock affected households ) , and their families often struggle to access basic services.
Nutrition partners modified delivery approaches by pivoting to mobile health and nutrition services to ensure nutrition services reach those who are unable or unwilling to access health centres due to COVID related movement restrictions or fear of approaching health facilities. They also developed COVID 19 specific guidance for Integrated Management of Acute Malnutrition
Hard data on the prevalence of Gender Based Violence  ( GBV )  is scarce due to inherent weaknesses in the legal system, a fragile health system, engrained social norms and a lack of social safety networks, which all conspire to make reporting challenging for most victims.
Miserable living conditions, drug addiction, and poor psychological health are among the most reported causes of increasing levels of family violence, in addition to pre existing, persistent gender and social inequalities, as well as discrimination related to socio cultural practices.
The cumulative impact of conflict  and disaster related shocks, as well as limited opportunities for recovery have depleted the psychological and financial reserves of millions of Afghans.
The Support Platform for the Solutions Strategy for Afghan Refugees must prioritize child focused solutions that protect the rights of all children regardless of status including access to education, health care, access to clean drinking water and other essential services
Due to the negative impact of the outbreak, the vulnerability of the households further increased and already existing dangerous coping strategies such as child labor, child marriage and decrease of food consumption have been worsened by financial insecurity for families and losses of household income.
A third of the population – including 7.3 million children will face food shortages due to the impacts of the current pandemic according to Save the Children2.
With the addition of COVID 19 and its immediate and secondary impacts, children are now more anxious and worried than ever before and at greater risk of facing physical, sexual and emotional violence, especially as the economic impacts of the crisis set in with poverty rates and hunger in the country rising.
571,800 total returns from Iran, 5,001 total returns from Pakistan.
A Risk Communications and Community Engagement Working Group was also established to support urgent COVID 19 information needs. It is now part of the wider AAP Working Group which has just been established to support greater accountability to affected people across the response.
With the HRP only 24 per cent funded at the mid year point, adequate resources to meet heightened, inter sectoral needs have yet to materialise. While substantial carry over funds have enabled the response to scale up, it will not be possible to maintain this level of assistance without an urgent injection of funds.
While impact has been felt across the board, women have been particularly affected, losing both informal and formal labour opportunities at higher rates than male counterparts while also absorbing increased burdens of unpaid domestic and care work, particularly with the closure of schools.
As of 30 June, health workers made up 5 per cent of the total reported COVID 19 cases  ( 1,592 people )  and 18 deaths.
The main sources of income reported by displaced households in the 30 days prior to data collection were from unsustainable sources including unskilled labour  ( average of 599 AFN/$7.58 per household member per month )  and borrowing/loans  ( average of 546 AFN/ $6.92 per household member per month ) . As such, living conditions for IDPs in displacement sites are especially harsh. Poor shelter and unhygienic WASH conditions leave people vulnerable to disease and unable to cope with Afghanistan's harsh winters.
In the WOA Assessment, displaced households reported that they are spending 75 per cent of their total income on basic needs  ( food, water for drinking, and rent and shelter materials/labour ) , with the majority of total income,  ( 63 per cent )  being spent on food, leaving little room for other expenses.
Women and children continue to bear the brunt of the conflict and accounted for 44 per cent of all civilian casualties in the first three quarters of 2020.
Health is most often the entry point for victims of GBV. The limited physical and psychological treatment available for victims of GBV continues to affect their recovery.
WoA Assessment data shows that 87 per cent of non recent IDPs intend to remain in their current location in the short term and more than half never intend to return to their place of origin.
Tuberculosis, HIV/ AIDS and other sexually transmitted infections are increasingly prevalent among migrants in many parts of Afghanistan, rapidly making the issue of migrant health a priority.
Recent Health Cluster estimates suggest that more than 7 million people have no or limited access to essential health services due to insufficient coverage by the public health sector and direct interruptions due to conflict and insecurity.
Due to the combination of high rental costs and limited labor opportunities, IDPs face a high risk of evictions.
Child casualties amounted to 31 per cent of all civilian casualties in the first 9 months of 2020.
People's eroded resilience capacities make them susceptible to sliding down into acute malnutrition, irrespective of the degree of severity of the shock. This reduced coping capacity has been compounded by ongoing conflict and recurrent disasters.
Girls' education has been disproportionately affected by the protracted crisis, cultural limitations, and now COVID 19.
Most crucial is to ensure continued and sufficient humanitarian assistance to face the many challenges ahead, especially the risks posed by COVID 19.
People mostly resort to using open fields, bushes or family pit latrines without slabs.
The unavailability of water sources as well as the distance to water sources are known to heighten the risk of GBV for women, girls, and boys who are responsible for fetching water.
Social distancing measures and lockdowns meant fewer people screened for and diagnosed with TB and those who were already on TB treatment facing difficulties obtaining their medications. These challenges can lead to decreased adherence, increased treatment failure, increased drug resistance, and other adverse outcomes.
This was the spur for a multiannual project run by Johanniter International Assistance and supported by the Federal Foreign Office from 2017 till the end of July 2020. A centre was set up in Gulan refugee camp in Khost province, south eastern Afghanistan, on the border with Pakistan, to provide basic healthcare for refugees as well as for the local population.
The limited number of female medical staff, as well as cultural limitations on women's movement, continue to restrict women's access to life saving treatment and services  ( both COVID 19 related and non COVID 19 related ) . For example, only approximately 50 per cent of pregnant women in Afghanistan deliver their children in a health facility with a skilled attendant, in contrast to the 70 80 per cent reported in many other low income countries.
Lack of access to health care has reduced people's living standards, with one third of the population  ( mostly in hard to reach areas )  unable to access a functional health facility within two hours.
Post traumatic stress is also widespread, affecting those in combat, while daily exposure to violence means many mothers, children and adolescents live with some form of distress, impairing them from their daily activities.
Food insecurity and livelihoods in urban areas have deteriorated severely over the past year with 40 per cent of households reporting a poor food consumption score in 2020 compared to 16 per cent in 2019.
A separate telephone survey was conducted by MOPH in May 2020 with randomly selected health volunteers  ( 713 )  who answered questions to help estimate COVID 19 morbidity in the country. The survey estimated that the proportion of people with COVID 19 signs and symptoms was 49.6 per cent.
In urban areas, where many protracted IDPs with insecure tenure are concentrated in informal settlements with insecure employment, people's capacity to maintain adequate food consumption is greatly reduced.
People returned without a good understanding of COVID 19 mitigation measures and without the financial nest egg they would usually have earnt overseas, leaving themselves and host communities extremely vulnerable.
World Bank estimates show that income from remittances has decreased by up to 40 per cent in 2020  ( as compared to 2019 ) , as a result of COVID 19 and population movements.
Attacks on health facilities and personnel frequently lead to closures affecting health access for hundreds of thousands of people and resulting in unmet health needs.
This is forcing agricultural families to cover the rest of their food needs through other external sources – savings, sale of productive assets and livestock, borrowing food, working for food, and sending household members out of the country to work and send money back.
Food shortages threaten the immediate survival and wellbeing of people.
Weak health systems and disrupted access to health care, partly owing to decades of war, disaster and under investment, have left millions of Afghans with mounting health needs in the face of a global pandemic.
In 2021, some 17.6 million people are in need of both food assistance and livelihoods support. This includes people displaced due to conflict or natural disasters, people affected by shocks including COVID 19, returnees, refugees and acutely vulnerable people in crisis and emergency levels of food insecurity.
The deterioration in the food security situation has posed significant threats to people's immediate survival and wellbeing. Combined with other factors, it has also fuelled surging acute malnutrition particularly among for women and children.
Almost three quarters  ( 72 per cent )  of IDP households are living in a shelter without any written documentation establishing their right to be there.
Many people are unable to afford rent and fear eviction.
Loss of remittances, loss of livelihood opportunities in places of return and loss of family support networks all add to returnees' vulnerability.
Some 50 per cent of non recent IDPs, 46 per cent recent IDPs, 45 per cent of non recent returnees, 38 per cent of recent returnees, and 13 per cent acutely vulnerable people report living in a settlement without official permission to live or build.
Lack of appropriate documentation  ( with people either having never had formal documents or having lost them during displacement ) , coupled with limited processes and infrastructure to formalise or re issue documents, poses high risks of eviction, exploitation, rights violations  ( by landlords )  and potential disputes due to the difficulties in demonstrating ownership of land/shelter.
People who have been displaced for a prolonged period or multiple times are acutely vulnerable due to their depleted financial and emotional reserves.
Recent IDPs have the greatest EiE needs with only 21 per cent of IDP children attending school four or more days per week on average prior to the pandemic – 82 per cent of the girls and 68 per cent of the boys were not enrolled in school.
COVID 19 has also magnified existing gaps in availability of water, sanitation facilities and hygiene materials in schools and CBEs.
This constant interruption to education, as well as the inadequate availability of schools and teachers have grave consequences for children's capacity to thrive and contribute to the economic and civic future of their country.
Attacks on schools have also undermined the right of children to a safe learning environment, compromising their physical and psychological wellbeing.
The limited ability of Afghan families to mitigate against the effects of unexpected income losses means they have turned to potentially harmful coping strategies, such as reducing spending on education and food or selling assets.
Loss of livelihood and increased food prices have increased household vulnerability.
With the onset of COVID 19 and restrictions designed to slow the spread of the virus, the limited access to education that did exist was shuttered for more than six months for more than 10 million children, leaving them with education deficits and catch up learning needs.
Prolonged absence from school coupled with limited access to television and radio based distance learning programming in many parts of the country, especially in rural areas, resulted in the loss of access to education.
Preliminary analysis suggests that COVID 19 lockdowns in 2020 disproportionally affected urban areas, where restrictions on movement were more heavily enforced.
Further, ensuring adequate supplies of food for nutritionally vulnerable populations such as pregnant and lactating mothers, anaemic adolescent girls, and malnourished children, boys and girls, has become a significant development challenge in Afghanistan, requiring humanitarian nutrition treatment when their situations become acute.