The Islamic Transitional Government of
Afghanistan
Ministry of Public Health
Health and Nutrition Sector Coordination Report
Reporting Period: 7-13 September 2002
Email to submit information for next week's newsletter: registry@afg.emro.who.int (mention in subject line:
“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
National technical coordination committee
After the introduction of the meeting by Dr Fahim, the review of September 2002 NIDs, and the update of
the CHW task force ( see below) , a report on the progress on Performance-Based Project Agreements
(PPAs) was presented: The 10 provinces where the PPAs will be implemented have been identified , a
selection committee for NGOs application will begin to work from October 2002 and indicators of NGOs
performance have been identified.
The national facility survey team (MSH) presented a progress report indicating that 90% of the data is
compiled and that final results will be presented during a national workshop in October.
A discussion about WFP Protracted Relief and Recovery Operation (PRRO) 2003-2005 made requests for
specific food aid needs for TB patients. Further comments on the role of food aid in health and nutrition
should be given to Annalies Borrel (Nutrition/Food Security adviser to MOPH) or Gretchen Bloom in WFP.
The incentive salary workforce team announced that an MOU has been developed to be signed between
MoPH and NGOs employing MoPH staff. NGOs who are not willing to sign the MOU will be pursued by
the regulation of MOPH and might be penalized and expelled. A Hardship allowance should top up the
scale wherever applicable.
UNFPA announced the opening of an Internet café at the MoPH from 8:oo to 16:oo. UNICEF announced
the SMI workshop on September 17-19, 2002. Dr. Atefi from Health Education and Publication
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Department of MOPH mentioned that his department is in the process of developing National Guidelines
Manual for Health Education.
The next NTCC will be held on October 13 at 10:00 at the Library hall of the MOPH with the following
Agenda:
1. Report on EPI review workshop
2. Control of ARI
3. PPAs update
4. Progress on Facility Survey project of MSH
5. Salary/Incentive taskforce update
6. Finalization of CHW functions
7. Finalization of BSP
National development budget:


Peter Middlebrook indicated that the Ministry of finance will support the working group on national
development budget and will give further clarification on the objective of the exercise.
The next group will meet on Sunday September 15th, the final product will be rather indicative than
exact.
Global fund to fight AIDS TB and Malaria
A meeting was held on September 11 between the Global Fund Common Coordinating Mechanism and
MoPH/WHO/NGO representatives nominated by the TB technical committee and Malaria Task force and
MoPH. Under instructions from the Programme Secretariat, a modest proposal to build implementing
capacity is being prepared (deadline 27 September 2002).
Program secretariat:
The working group on CHWs is still developing the training guidelines terms of reference such as the use
of injectable antibiotics will be deferred under the 23-25 September workshop on community based health
care
Sub-sectors
EPI & Polio Eradication
First Inter Agency Coordination Committee (ICC) for EPI activities meeting was held on September 15th,
2002 in Ministry of Public Health, Kabul. Meeting was presided by Dr. Abdullah Fahim, Head of Foreign
Relations Department, MoPH, and attended by Ministry of Finance, other members and donors
representative.
Her Excellency, Minister of Public Health in her written message for 1 st session of ICC, showed full
commitment of MoPH to decrease the mortality and morbidity of children in Afghanistan and all EPI
related activities.
Ministry of Public Health agreed the proposed loan by the World Bank and IDA for the procurement of
OPV through UNICEF for the year 2003 and 2004.
During this period one case in Kabul was confirmed as wild Poliovirus type P1, after 2 years of no wild
virus in the region.
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In addition 17 new Acute Flaccid Paralysis cases were reported by focal points all over the country.

With the two more confirmed polio cases detected this month, the total number of confirmed polio
cases are seven in 2002.

UNICEF is planning for total Office Mobilization (TOM) for the 2nd round of fall NID which will be
held from 22-24th of October 2002. UNICEF Representative in Afghanistan, Dr. Eric Laroche has
already circulated a message to all staff members indicating the importance of the forthcoming
NID for halting the transmission of poliovirus in the country by the end of 2002.
UNICEF/WHO/MOPH team members will visit each and every district in the country to ensure the
quality of National Immunization Day. We are also expecting high officials from WHO & UNICEF
HQs during the next round of NID.
Maternal and Child Health
MCH Working Group meeting was held on 15 September 2002 at UNFPA office in Kabul .The meeting
was chaired by MCH Dept./ MOPH Director. Since last month the group has met on weekly basis and
have discussed on functions of MCH clinics, job description for MCH staff and mapping of MCH clinics in
Kabul city. Draft job descriptions for Director of MCH clinic, Pediatrician, Obstetrician, pediatric Nurse and
Midwife have been developed during the meeting.
Main outputs:
- sharing of the safe Motherhood strategic framework, focusing on three axes: increase coverage,
utilization and quality of Emergency Obstetric Care services; increase coverage of skilled attendance at
birth; ensure effective antenatal care interventions through health servioces and community based
interventions, while ensuring the link with the FP services.
- review of the evidence-based practices which are the background of the strategy;
- overview of the main interventions to ensure the implementation of the strategy;
- definition and endorsement of the roles and responsibilities of each stakleholder involved in the SMI
implementation
- forecast of activities - next 4 wks, next 6 mts and up top the end 2003;
- consensus on going towards implementation and organize in the next month regional workshops which
will allow to all partners at the grassroots to identify and plan their activities for making safe motherhood
Live and Saving women's lives.
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Nutrition

UNICEF’s support continued on supplementary feeding interventions in 174 feeding centers
implemented by NGO partners. In Mazar, eight agreements on blanket feeding for children,
pregnant and lactating women have been approved.

The monthly meeting by the National Nutrition Coordination Committee meeting, jointly organized
by UNICEF and the Ministry of Public Health was conducted on 8 September in Kabul. A total of
31 participants from partner agencies, including NGos, NGO and UN agencies involved in
nutrition activities participated in the meeting. The meeting focused on protocols, mainly
supplementary feeding and macronutrients; mapping of feeding centers; plan of action on
therapeutic feeding, micronutrient deficiency; and updates on infant and young child feeding
practices. Information on training events was also shared in the meeting.

Preliminary work on the analysis on the situation of salt in Herat and Mazar, and the feasibility of
salt iodization initiated with the assistance of an expert
Communicable Diseases
The situation of diarrheal diseases is under control. No news about outbreaks. Separate meetings have
been taken with MoPH director of communicable disease control. On the agenda was preparedness for
ARI in the winter in terms of training, logistic and project monitoring and supervision was a main topic of
discussion.
Malaria, Leishmaniasis
A National malaria task force meeting was held on 10.9.02 with partners : Current treatment protocol for
uncomplicated Pf malaria (first line CQ, second line SP, third line quinine) endorsed pending results of
efficacy studies (one underway in Jalalabad, one to commence site yet to be selected) –Institute of
Malaria and Parasitic Diseases (IMPD) to disseminate protocol. Pf outbreak season commenced: IM
artemether plus rapid tests to be made available by WHO for use in peripheral settings/high mortality Pf
outbreaks – IMPD to disseminate protocol.
Outbreak reported in Imamsahib (Kunduz province) - to be investigated
Water supply and sanitation
Emergency chlorination project initiated on July 18,02 is on going. WHO is providing technical assistance
as well as the hygiene education materials. Accordingly, third round is launched and chlorination of water
sources in suspected areas is on going. UNICEF has agreed in response to WHO recommendation to
proceed with the third round. The fourth round would be undertaken by WHO in case of need.
CWS team is preparing to start rehabilitation of Kunduz Water Supply Project. CWS team participated in
the urban water supply rehabilitation meeting held under the auspices of the Ministry of Town Planning
and Housing.
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Overview of Geographic Areas
Central Area
EPI / PEI activities:
FR-1 NIDs 2002 Coverage in Central Region is as follows:
Province
Target
Coverage
Percentage
Kabul city
451,390
452,158
100.2
Kabul districts
153,806
173,801
113
Wardak
139,378
138,553
99.4
Logar
86,124
87,899
98.1
Parwan
143,114
140,360
98.1
Kapisa South
45,908
48,447
105.5
Bamyan North
60,245
61,119
101
The Bamyan south and Kapisa north coverage are being collected for the moment.
Monitoring findings of the implementation of NIDs are as follows;
Province
Kabul
Wardak
Kapisa
Parwan
Logar
Bamyan
H.H
1,998
2,046
,770
1,300
,428
, 226
Children monitored
4,176
5,923
1,359
1,626
1,552
, 590
Vaccinated
3,748
5,740
1,337
1,589
1,533
,564
Missed
392
183
22
37
19
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Monitoring findings thoroughly analyzed and appropriate measures taken to ensure the overall
achievement. The role of the MoPH and subsequently the REMT was leading in that regard.
Coordination meeting: the coordination meeting has taken place at WHO office for the preparation for
the next round of NIDs from 22-24th of October. The aim is to reach the last child in the remotest area in
Afghanistan.
Review meeting: On 12th of September a review meeting has taken place at WHO office where REMT
colleagues have reviewed the strong points of the campaigns as well as the challenges and means of
strengthening of the campaign.
Nomadic movements were also discussed and finally it was agreed to assign special mobile teams on the
route to make sure that there is no missed children among their children. A total of 19 teams will be
deployed for that task. Their work will be for one week
AFP Surveillance:
Two AFP cases have been detected this week from Shakardara, and Nawor district of Ghazni province.
All epidemiological reviews have been completed.
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A mission is in Qarghanato/Bamyan to assess the vaccination status in the vicinity of the AFP case
number AFG/11/02/07. Final report will be presented for discussion.
Northern Area, Mazar
A mission went in Aaqcha district to assess the possibility of opening a TB center in this district that will
also cover Murdain and Mingajik neighboring districts. Accord was found between MOPH and WHO to
initiate TB activities in this district, with identification of the TB center and staff, preparation of specific
training, list of equipment and drugs needed. All TB centers of the region have been receiving TB drugs
this week as well as BP5 and BP100 biscuits. A TB training for the medical doctors and TB coordinator
will begin form September 28 for 12 days.
Kunduz,
The CDD training course of 20 Medical doctors and health workers in Kunduz was completed this week.
Health partners are preparing a new assessment mission with HNI, MRC and WHO to evaluate progress
concerning the malaria outbreak in the area.
Faizabad,
A plan for the 2002-2005 construction of health clinics in Badakhakn Province is under preparation.
WHO will begin to equip the new MCH clinics newly built in the area. Monitoring of post-Nids is under way.
Western Area, Herat
There is a plan to send 10 doctors from Herat, Badghis, Farah, and Ghor to Aqa Khan University in
Karashi for one month training on reproductive health and nutrition. As well, 10 Laboratory technicians will
be sent in Kabul for training. These training are supported by GTZ.
The measles vaccination campaign began in Badghis province.
CHA has started the support of Shib Koh and Posht Kih clinics in Ghor Province and of Adraskan and
Rawashan clinics of Heart Province.
Southern Area, Kandahar
2 AFP cases were detected in Shanjoy district of Zabul and Dilaram district of Nimroz province.
In preparation of winter, new emergency health kits are distributed in Urozgan region and IDP camps in
Panjwai district.
MSF has opened a health center in Zhary Disht new IDP camp where IDPs will be relocated for three
months.
Southeastern Area, Ghazni
A three days training courses on malaria prevention for VHVs was conducted in Moqor, for 15 VHVs from
Moqor, Andar, Qara Bagh districts of Ghazni. A new training will begin for 20 new VHVs this week.
As well, 20 TBAs will be trained from Moqor district of Ghazni.
In Jermatu village, the community is building their own 2 rooms health center, supported by WHO-BDN
program and their own funds.
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Eastern Area, Jalalabad
Plan is prepared for 2 refresher trainings of 50 TBAs trained in 2000, in Nasir Khil and Kolalai villages of
Hesarak district.
Plan is prepared for training of 120 health workers on Primary health cares. 20 participants have
completed the course in Nangahar this week.
Missions completed / ongoing / planned

September 17,2002: The vice- President of US base population service international will visit
Afghanistan and meet MOPH concerning social marketing messages and other matter.

Mr Eugene Dewey, Assistant secretary of Population, refugee and Migration Programme from the
Us State department will visit Afghanistan for 4 weeks, from the beginning of next week.
Meetings:

September 17, hotel Kabul: Reproductive Health Task Force

September 23, IMPD: Leishmania Task Force

October 8: 10 am IMPD: Malaria Task Force

October 13, 10:00 A.M. MoPH: NTCC Meeting

October 20, 10:30: Nutrition Task Force
Calendar of forthcoming activities

17–19 September 2002, Safe motherhood initiative workshop, Kabul hotel

September 23-25, Khyber Restaurant, Workshop on National Community-Based Health Care,
MoPH, WHO, UNICEF and MSH

September 23-25, Insaf Restaurant, Workshop on Eye Care Strategic, MoPH, CBM, WHO and
IAM

5-6 October 2002, 3rd DOTS/TB expansion working group meeting, Montreal, Canada

16-20 September 2002, Second Global Team Meeting on Making Pregnancy Safer (MPS),
Geneva, Switzerland.

21-23 October 2002, International conference on wastewater management and its effect on the
environment in hot and arid countries, Muscat, Oman.
For more information:
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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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