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National Reproductive Health Strategy (2012–2016)family planning in the community. As part of its efforts to increase community participationin FP activities, FHAGs, CHWs and CMWs will be trained to mobilize the elder women of theircommunity.2.4.6. Improve IPC skills of health workers in all provincesDeficient IPC skills resulting in inadequate counselling and lack of respect for client privacycontinue to be a barrier to the delivery of FP services at all levels. Training in IPC will berevised and strengthened in collaboration with the RHD’s partners, and an increasingnumber of health workers who deliver FP services in all provinces will be trained.Strategic Approach 2.5: Strengthen monitoring and evaluation of BS/FP activities2.5.1. Improve monitoring of BS/ FP service utilization, quality of services and follow-upAs in the case of MNH, data for monitoring is inconsistently collected at the provincial anddistrict levels, and often it is not analyzed or used appropriately. In collaboration withpartners, RHD will strengthen collection and analysis of monitoring data on serviceutilization and quality.2.5.2 Establish system whereby M&E data is fed back to users and utilized in decision makingWorking with partners, the RHD will strengthen its capacity to track key indicators in BS/ FPreporting as well as the interpretation and dissemination of results. Feedback mechanismswill be reinforced to ensure that relevant information is given to BS/FP service units andproviders in a timely way for use in decision-making.Monitoring indicators: Percentage of primary health care facilities providing at least three modern familyplanning methodsContraceptive prevalence (percentage of women or their partners using acontraceptive method at a particular point in time)Unmet need for family planning (proportion of married women 15–49 years who donot want any more children during the next two years but are not using any methodof contraception) Adolescent birth rate (number of live births per 1,000 population of women 15–19years)Percentage of health service delivery points providing youth-friendly servicesPercentage of health providers trained in youth-friendly service provisionStrategic Approach 2.6: Strengthen BS/FP services through the private sector2.6.1. Private sector should follow MoPH standard protocols and IEC/BCC materials in BS/FP2.6.2. Private sector should report regularly to MoPH at the provincial and central levelsMonitoring indicators: Percentage of primary health care facilities providing at least three modern birthspacing/family planning methodsContraceptive prevalence (percentage of women or their partners using acontraceptive method at a particular point in time)Page 20
National Reproductive Health Strategy (2012–2016)Unmet need for BP/FP (proportion of married women 15–49 years who do not wantany more children during the next two years but are not using any method ofcontraception)Percentage of women referred to health facilities by CHWs Adolescent birth rate (number of live births per 1,000 population of women 15–19years)Component 3: Sexually Transmitted Infections and HIV/AIDSThe extent and nature of sexually transmitted infections (STIs) in Afghanistan is largely unknown,because no prevalence studies have been conducted yet. National-level prevention, diagnosis,management and follow-up of STIs have not been the responsibility of any division of the MoPH untilnow. Because of the close link between RH and STIs, the RHD will initiate an STI interventionstrategy. Since STIs and HIV/AIDS are also closely linked, RHD will coordinate with the activities ofthe HIV/AIDS Control Programme and its partners, the Curative Medicine, Child and AdolescentHealth and BPHS Directorates, and the GCMU. Elements of the new STI strategy are listed below.Strategic Approach 3.1: Improve the quality of STI clinical services3.1.1. Integrate STI management and HIV screening and primary prevention into BPHS and EPHSservices3.1.2. Monitor progress in STIs using the Health Management Information System (HMIS)3.1.3. Identify resources for further STI/HIV/AIDS prevalence researchStrategic Approach 3.2: Build health workers’ capacity in STI management3.2.1 Collaborate with implementing partners to allocate resources for the training of healthworkers in STI prevention, identification and treatment Coordinate with implementing partners for the development of an LRP for STIs.Coordinate with implementing partners the implementation of an STI training programfor health workers in STI management including the syndromic approach.Include STI management in RH workers job descriptions.Strategic Approach 3.3: Increase public awareness of STIs3.3.1. Collaborate with the IEC and HIV/AIDS departments on the development of IEC/BCCmaterials for STI prevention, including those that promote condom useMonitoring indicators: Percentage of young men and women age 15–24 years (the at-risk group) who havecorrect comprehensive knowledge of STI/HIV preventionPercentage of new cases identified through the HMISComponent 4: Strategic Approaches to Breast and Cervical CancerOnly very limited services are available in Afghanistan for the diagnosis and treatment of breast andcervical cancer. No radiotherapy or chemotherapy centres exist in the country. Similarly, expertise insurgical treatment of breast and cervical cancers is only minimally available. The total mortality ratePage 21
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