WHO Emergencies Programme Report: Saving Lives, Protecting the Vulnerable and Responding to Life-Threatening Emergencies in Afghanistan
Executive summary
In 2023, Afghanistan is still making efforts to deal with the impact of over four decades of conflict, political instability, recurrent natural disasters, climate change and infectious disease outbreaks.
Out of a population of around 43.1 million, more than 23% of people live in underserved areas of the country.
Since August 2021, the Afghan economy has shrunk by 25%, unemployment has more than doubled and underemployment has increased by almost one quarter. In 2023, 65% of families reported directly experiencing economic shock, an increase of 20% since 2022. Poverty affects one in every two Afghan people, with 80% of households living on less than US$ 1 a day per member and more than 13 million people (29% of the population) facing a high level of food insecurity (IPC Phase 3 and above). In October 2023, a series of three 6.3-magnitude earthquakes struck Herat province in just eight days, killing nearly 1500 people and injuring approximately 2000, destroying around 40 000 homes and leaving 275 000 people in urgent need of shelter and emergency health interventions. Additionally, flooding in 2023 affected nearly 27 600 people across 26 provinces, destroying agricultural land, crops and infrastructure.
Despite the challenges, WHO implemented various interventions and recorded notable achievements in support of people in need. In 2023, the Health Cluster engaged with over 70 partners, of which 62 (four United Nations agencies, 26 international nongovernmental organizations and 32 national nongovernmental organizations) reported their activities through the ReportHub.
WHO and partners reached 16.5 million people (47% women, 21% men, 16% girls and 16% boys) across 89 districts in all 34 provinces. Throughout 2023, WHO Afghanistan implemented targeted primary health care (PHC) interventions, supported 317 PHC centres and installed 44 connexes/health facilities, covering 33 provinces and approximately 3 million beneficiaries (60% of which were female). In addition, 4 205 800 people benefited from medical supplies provided to WHO-supported secondary health care facilities.
In response to the returnee crisis, WHO and Health Cluster partners deployed an integrated response to reach 208 928 returnees (74 359 women, 52 165 men, 43 344 girls and 39 060 boys) with various health services encompassing primary and secondary health care interventions.
In 2023, in addition to distributing trauma and emergency surgery kits, the WHO Health Emergencies Programme (WHE) trauma team reached more than 229 227 Afghan patients and trained 51 health professionals on mass casualty management, with a special focus on senior health facility and health management staff.
There was a total of 1138 outbreak alerts in 2023, of which 1106 (97.2%) were responded to within 24–48 hours and 367 (33.2%) were laboratory-confirmed. Electronic surveillance was rolled out in 254 sentinel surveillance sites, and 295 sentinel surveillance focal points, 195 surveillance support teams and 74 national disease surveillance and response staff were trained on surveillance procedures. As part of nutrition interventions, WHO-supported facilities admitted and treated 50 588 children (25 800 boys and 24 788 girls) with complicated severe acute malnutrition.
WHE also strengthened reproductive health interventions in emergency settings: 41 881 women of childbearing age received family planning services (including counselling) and 6076 deliveries were conducted by the target hospitals. A total of 37 hospitals were supplied with 222 essential reproductive health kits.
During January–December, a total of 194 722 people received mental health consultations and 181 744 received immediate psychosocial counselling. WHO provided operational support to five pilot drug addiction treatment centres in a joint project with the United Nations Office on Drugs and Crime (UNODC). A total of 974 people with drug use disorders (852 adult males, 74 adult females, 18 adolescent males, 1 adolescent female and 29 children) completed drug treatment services in six provinces, while 3132 clients received pretreatment motivational counselling.
In response to the rising trends in noncommunicable diseases (NCDs), WHE adapted the WHO Package of Essential NCD interventions (WHO PEN) to the Afghanistan context and conducted PEN training-oftrainers in Kabul for 25 physicians and 12 midwives.
A total of 33 587 women and 27 000 men received sexual exploitation and abuse (SEA) awarenessraising information, and 269 frontline health care providers including 77 doctors, 101 midwives, 87 nurses and 4 psychosocial counsellors (78% female) received five days of training on prevention of SEA and health response to gender-based violence (GBV) in emergency settings. Moreover, a total of 1727 GBV cases were reported to and received advanced treatment in the national advanced GBV referral centre, of which 99% (1727) were female and 1% were male survivors.
The Programme Monitoring Unit conducted 1152 monitoring missions (Health Emergency Response project’s 96 hospitals) and 2803 monitoring visits (WHO-supported projects) country-wide. The overall client and patient satisfaction rate during 2023 was 88%. Overall, WHO supplied 13 590 medical kits to 837 health facilities for 14 909 200 beneficiaries. WHO appreciates the support of various stakeholders, United Nations agencies and Health Cluster partners, the donor community, and the people of Afghanistan as we work together across the country. This report provides an overview of WHE’s work in Afghanistan in support of people in need, especially in underserved areas.