Report - United States Department of Defense

UNCLASSIFIED
Afghan Government. Currently, the systems and internal controls needed to both determine
appropriate O&M spending levels and ensure that the amounts budgeted for O&M are deployed
and disbursed for the appropriate activities, are uniformly deficient throughout the ministries.
The Afghan Government must maintain this political will for reforms to grow internal capacity
in order to sustain existing infrastructure. Improvements in capacity will support both the
budgeting process for O&M costs, as well as the disbursement of the O&M budget throughout
the year, thereby increasing the likelihood of sustainability for assets and service delivery.
4.3: HEALTH
USG assistance to the Afghan health sector, focused primarily on increasing access to health
services to 90 percent of the population by the end of 2013 and reducing under-five and maternal
mortality by 50 percent by 2015, is directly linked to impressive gains in national health
indicators. Key positive results and connections to U.S.-supported programs are illustrated in the
USAID and other donor-funded surveys. These include the Afghanistan Mortality Survey 2010
(AMS), as well as the annual household survey of health status in the 13 USG-supported
provinces. Survey data are especially pertinent, since the 13 provinces represent approximately
51 percent of the current Afghan population.
While this is significant progress, Afghanistan continues to have some of the poorest health
indicators in the world. The health situation of women and children remains grim, particularly
among migrant and rural populations, including people living in insecure areas. For example, 88
percent of married women do not use any method of family planning, and only 56 percent of all
Afghans have access to clean drinking water. High levels of chronic and seasonal malnutrition,
and the widespread prevalence of infectious diseases, including polio (26 cases during 2012) and
tuberculosis, continue to contribute to high levels of morbidity and mortality.
To maintain and consolidate the gains made, and to move toward sustained efforts, USAID
works in partnership with the Afghan government to reach four goals:
1- Meet the immediate healthcare needs of the population by supporting the provision of primary
healthcare services);
2- Address the long term sustainability of the healthcare system by strengthening the capacity of
the Afghan Ministry of Public Health (MoPH) at the central and sub-national level;
3- Improve the health related behaviors of individuals, families, and communities; and
4- Increase demand and access to quality health products and services through the private sector.
Key achievements and challenges
In 2012, USAID continued to build government capacity at the central and provincial levels to
better manage the delivery of quality health services, with a focus on strengthening leadership,
resource management, monitoring, and policy and strategy development. For example,
specialized technical assistance enhanced the Ministry’s Health Management Information
Systems (HMIS). As a result, 91 percent of facilities in USAID-supported provinces reported
data in the HMIS during 2012.
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