The Islamic Transitional Government of
Afghanistan
Ministry of Public Health
Health and Nutrition Sector Coordination Report
Reporting Period: 12-18 October 2002
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“for weekly update on health sector”. Reports can also be requested through this address.)
Contents
Coordination
Sub-sectors
Regional overview
Missions to Afghanistan, international meetings/ training & workshops
Surveys and assessments
Calendar of forthcoming activities
Coordination
Program secretariat
The PS discussed some concerns regarding the draft World Bank PPA TORs. The concerns will be raised
with the World Bank in writing and further discussed during the upcoming conference call.
The TAPA submission deadline is October 20. Between 21-31 October the TAPA technical review panel
(composed of the PS and two NGO panelists, AKDN and AIM) will review all submissions. The final
recommendations of the review panel must be submitted to Ministry of Finance and AACA by 1
November.
Implementation Group
The Implementation Group meeting was held 12-14 October. At the IG meeting the government launched
the National Development Budget (FY 1381, 1382), which will be the driving force for national priority
setting and donor coordination. Twelve programs are listed in the NDB, and six national priority projects
have been identified (education and health, road building, water and power, urban development, rural
development, and reconstruction of government buildings in all districts). The percentage allocations of
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the overall budget have been agreed (45% to Pillar 1, human and social capital, 35% to Pillar 2, physical
capital, and 20% to Pillar 3, trade and investment).
The IG will become the CG (Consultative Group) and the next donor meeting, the first CG meeting, will be
held in Kabul in February 2003.
Sub-sectors
EPI & Polio Eradication
Arrangements are in full swing to implement the second round of polio NIDs throughout the country. The
logistics including vaccine has already been dispatched and received in most of the locations. Vitamin-A
would also be administered to all children between the ages of 06 months to 05 years in this round.
Special emphasis has been made to further streamline the post-NIDs monitoring to ensure consistently
high quality coverage during the forthcoming rounds. Most of the regions are setting a minimum of 95%
coverage as determined through post-NIDs monitoring results in each cluster to be acceptable, before
payment of incentives is made to the implementing staff. Any coverage lower than the basic minimum
would require the teams to go back to the houses and cover the remaining children.
Dr. Daniel Tarantola, Director Vaccines and Biological and Special Advisor to the Director General of
WHO is visiting Kabul from 20-23 October to inaugurate NIDs and review the progress of the polio
programme in the country. He would also be meeting the senior UN staff and diplomats from some of the
donor countries.
UNICEF has mobilized its entire office to monitor the NIDs activities in the field. Around 300 people will be
monitoring NID activities throughout the country. Other preparation was mentioned in the last week report.
One more polio case has been identified in Kunduz. Now the total number is eight.
Maternal and Child Health
Regional Safe Mother hood workshop for the Eastern region was held from 12-14 October, 2002 in
Jalalabad. Many NGOs, UN agencies and MOPH directorate from Eastern region were attended in the
workshop. The main purpose of the workshop was as follows:
-To share the content of the National Safe Motherhood strategy for reduction of Maternal Mortality in
Afghanistan
- To share the new approach for reduction of Maternal Mortality
- To identify the roles and responsibilities of each partners involved in the implementation of SMI
program
- To assess the needs for implementation of the SMI in all levels
- To draft an appropriate action plan for the duration of the 15 months (Oct, 2002-Dec2003)
MoPH in collaboration with NAC would like to conduct the full-fledged Midwifery Training in the eastern
region for the duration of the three years and 70 Midwives will receive training from different provinces of
the eastern region. WHO will provide teaching -training materials to the training as well as training of the
Master trainers. The standard guideline for midwifery training, which was revised by, WHO will use as a
reference materials in the training.
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Nutrition
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Operational research on Caring Practices, data collection continuing in Panjshier, started on the 7th
October.
Finalized salt situation analysis and plan of action for production of iodized salt in the Western,
northern, northeastern regions and Kabul/central region with a salt consultant.
Review of the International Assistance Mission (IAM), supper flour production, discussion started on
how to improve capacity and quality of production, IAM request/proposal for PCA with UNICEF being
revised.
Working group initiated by UNICEF/MoPH has started working on national strategy for management
of severe malnutrition and developing plans and training modules.
A total of 10 PCAs (Project Cooperation Agreement) finalized for mass vitamin C supplementation and
Supplementary Feeding Programs with 9 partner NGOs in the northern, western and eastern region.
Malaria
Training of teams from the Ministry of Public Health for the 2002 national malaria prevalence surveys
supported by WHO and partners including HNI and Hope Worldwide. National household survey data to
be collected includes age, sex, parasitemia, anemia and village altitude.
Training of MOPH research team for anti malarial drug efficacy study in Khanabad supported by MERLIN
and WHO.
Tuberculosis
The TB team has received the visit of Dr Mark Perkins, of TDR headquarters in Geneva. Dr Perkins is
interested in setting up laboratory facilities to support TB control program in Afghanistan and has been
granted funds from USAID for this purpose. In consultation with NTP, WHO has identified Mazar-e-Sharif
as the possible location of a regional center for the training of laboratory technicians and other health
cadres dealing with TB control in the Northern region. The WHO Stop TB Team is about to pay a visit to
Mazar in order to assess the feasibility of the project and discuss plans with the local authorities. If
successful, that of Mazar will be the first of 3 or 4 regional training center for TB and malaria to be
established in the country. The visit is planned to take place between 18 and 21 Oct.
Water supply and sanitation
The 4th round of emergency chlorination project of water sources in Kabul was launched this week and the
shallow wells in private houses and public places have been chlorinated this is to prevent the water borne
disease incidence in Kabul. CWS Water and Sanitation engineers facilitated a training workshop held in
Mazar. This training workshop was conducted jointly by EMRO and EURO, EURO supported the
Environmental Health expert and donated two Water testing Kits, one for the water supply authority and
the other one for MoPH of Mazar-e-Sharif. WHO, Afghanistan provided the water and sanitation engineers
to conduct the course jointly with EURO expert, and supported the other expenditures of training. WHO
Afghanistan also provided Water Testing Kits for the training workshop for practical training of the
participants.
CWS team leader and site engineers participated in the international conference on Waste Water
Management and its affects on the environment in hot and avid countries held in OMAN. This delegation
also visited the savage system of Muskat city. WHO site engineer currently in Kunduz is mobilizing
implementation of Rehabilitation of water supply system in Kunduz city.
Construction 100 VIP latrines in Kandahar city has been started and the work is going on according to the
schedule.
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Health Promotion
The Ministry of Public Health is in consultation with a working group of NGOs and UN agencies for the
development of national guidelines on health promotion. A workshop is planned for October 28-31,
sponsored by WHO, to finalize health messages elaborated by the working group. These messages will
be published in a manual to be used as a training resource for health professionals.
Health education training is underway for 20 female journalists attached to Radio Afghanistan. The
workshop was organized by UNICEF and is part of a women’s health radio project sponsored jointly by
UNICEF and WHO. Also as part of the Women’s Health Radio Project, HABITAT is currently training forty
supervisors from eight regions in Afghanistan who will, in turn, train 2000 women facilitators. These
facilitators will support 2000 women’s radio listening groups that are being set-up as part of the project.
Overview of Geographic Areas
Central Area
EPI / PEI activities:
A- Second round Fall NIDs 2002:
1-Preparation of FR-2 NIDs 2002(22-24 October 02):
Review of districts micro plans, re-orientation of District coordinators, Supervisors, Social mobilizers and
Volunteers have been completed.
2-Training of F-2 NIDs 02:
2-1 Training activities for all categories of NIDs participants in Hazarajat region for FR-2 NIDs 2002 has
been completed on 17th October 02.
2-2 Training of newly assigned coordinators and supervisors had been completed in Kabul city.
2-3 Orientation of Coordinators, supervisors and volunteers have been completed till 18 th Oct, 02
B-Measles mortality reduction campaign:
The MMRC campaign has been conducted in Mahmood Raqi and Kohistan districts, and their coverage
are as bellows:
Province
Kapisa
Total
District
Mahmoodraqi
Kohistan
Boys
11642
12454
24096
Girls
11167
12151
23318
Total
22809
24605
47,414
C-Social mobilization:
NIDs mobilization and motivation were going on through WHO, UNICEF, REMT and Ministry of Education.
Special orientation and involvement regarding the dissemination of NIDs messages have been toke place
in every high school.
D-Logistic and supplies:
Hazarajt areas supplies and logistics has been prepared and dispatched to Bamyan city and Panjab
districts.
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E-AFP Surveillance:
Three AFP cases have been detected this week from Charkh, district of Logar province, Jaghato district of
Wardak and Kohistan district of Kapisa provinces. The samples were collected in a good condition and
have sent in a good condition to the referral laboratory.
Meanwhile the AFP focal points, NIDs coordinators, Supervisors and volunteers have been encouraged
for timely detection of the AFP cases during NIDs and referring to AFP sentinel sites.
E-Inauguration.
There were several meetings with MOPH, UNICEF, WHO regarding the NIDs preparation and appropriate
inauguration and motivation in Amani High school.
Their Excellencies the minister of Public Health and the minister of Education have agreed to be
inaugurating the NIDs.
Faizabad
Visit of Dr El Badawai, for an assessment of BDN activities in Faizabad.
The activities of the week focus on preparation of the implementation of the second round of NIDs and the
social mobilization of the third round of NIDs.
Kunduz
Preparation of a chloroquine efficacy study in Kunduz, Khanabad district was selected as the site for the
study and training for malaria technicians and clinicians will begin next week.
The rehabilitation of the water supply system of Kunduz has been initiated, in collaboration with the
municipality and WHO.
A joint UNICEF/UNFPA team from Kabul visited health facilities in Kunduz city/districts as well as in
Takhar and discussed about their current activities and future plans for maternal health with partners. A
workshop will be held in mid Sept. for Kunduz and Takhar to share the Safe Motherhood strategy and
agree on an action points for the two provinces
Western Area, Heart
Suspicion of outbreak of typhoid fever in Charsada district of Ghor province, a team composed of IFRC,
MDM, CHA and WHO/EHA went in the area to assess the situation. EPI refresher training was hold in
Baghdis for staff form MOPH, IMC and world vision.
A regional Safe Motherhood workshop was conducted in Herat for the western region on October 13-15,
2002 following the September national Safe Motherhood Planning Workshop held in Kabul. The main
outcome of the workshop was: 1) Inventory of the current situation in the region with regards to MCH and
EmOC 2) Agree on expected outcomes/milestone till Dec. 2003, based on the Safe Motherhood national
strategy and 3) Agree on action points for the next 6 months.
Southern Area, Kandahar
In the last UNAMA coordination body, a specific appeal point was raised concerning the poor coverage of
health services in the area. “Out of 55 districts, 17 have no type of health facility. This should be one of the
priorities in any kind of rehabilitation and reconstruction programs in these districts. Donors interested in
these districts should take this issue seriously and consider Health as the top priority for those districts
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with no facilities. Further, the government should take over the control of the health center once
established or rehabilitated”.
Who started the construction of family latrines in Ghargi village. 100 latrines will be constructed within the
next three months.
Establishment of new sentinel sites for AFP have been established in Bagran, Mosaqala, kajaki and
Saraban qala as well as in Ghorak and Dand districts. Preparation of fall NIDs on going.
A regional Safe Motherhood workshop held in Kandahar for southern region on October 12-14, 2002,
which was following the September national Safe Motherhood Planning Workshop held in Kabul. The
representative of MoPH Kabul traveled to Kandahar and contributed in the facilitation of the workshop.
The main outcome of the workshop was: 1) Inventory of the current situation in the region with regards to
MCH and EMOC 2) Agree on expected outcomes/milestone till Dec. 2003 and 3) Agree on action points
for the next 6 months.
Southeastern Area, Ghazni
WHO has coordinated with Ghazni PHD and NGOs providing primary health care services in SER to
conduct training courses on management of primary health care in the region. In a special meeting with
Ghazni PHD, SCA, NAC, Ibn Sina, MSF, ARC and RRD, the training materials and time table prepared by
WHO were reviewed and the participants from the health facilities were selected for the course.The
training started on October 17 for 21 participants, in Ghazni civil hospital.
An other refresher-training course for 20 VHVs in Rashidan district was conducted in support to the
Ghazni PHD. VHVs received their kits after the training in order to be able to initiate their work directly.
In addition, the Paktya PHD trained TBAs who received their TBAs kits from WHO, a similar training for 50
other planned TBAs training had to be postponed due to security reasons.
A 6 month literacy training started in for 30 women of area-Jeramtu of Rashidan district of Ghazni,
supported by WHO BDN project.
Eastern Area, Jalalabad
Project of training for 5 districts of Kunar in district health management team and plan for strengthening
the general health services of Kunar district were formulated during a meeting held by the Public health
director of Kunar province.
Japan International Volunteers Center newly arrived in Nangahar and project to develop BDN programs in
Nangahar.
A regional Safe Motherhood workshop held in Jalalabad for eastern region on October 12-14, 2002, which
was following the September national Safe Motherhood Planning Workshop held in Kabul. The main
outcome of the workshop was: 1) Inventory of the current situation in the region with regards to MCH and
EmOC 2) Agree on expected outcomes/milestone till Dec. 2003, based on the Safe Motherhood national
strategy and 3) Agree on action points for the next 6 months.
Missions completed / ongoing / planned
Dr Tarantula, Head of vaccines and biologicals in WHO Geneva will visit Afghanistan from October 20 to
October 23, to review the EPI/Polio project and inaugurate, with the Minister of Public Health, the second
round of NIDs on October 21, 2002
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Meetings & workshops
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October 20, 10:30: nutrition task force Library of the MOPH
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October 23, 2002: communicable diseases task force.
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October 28, 10:00: Reproductive health task force at the library of the MOPH
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November 4, 10:00: NTCC at the library of MOPH
Calendar of forthcoming activities
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21-23 October 2002, International conference on wastewater management and its effect on the
environment in hot and arid countries, Muscat, Oman.
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December 10 to 12, 2002. Workshop on emergency preparedness and response of the health
sector in Afghanistan. Kabul.
For more information:
WHO Afghanistan Office
House No. 249, Street No. 10
Wazir Akbar Khan Mina
Kabul, Afghanistan
Tel: (0093) 70279010/1-2
Digital lines : 2300181/2
E-mail : registry@afg.emro.who.int
Fax No : 0047 233 08112 2207
WHO Afghanistan Support Office
P. O. Box No. 1936
House 218, Margalla Road, F-10/3
Islamabad, Pakistan
Tel: (92 51) 221 1224, 2104770.4
Fax: (92 51) 228 0830
E-mail: supply@whoafg.org
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