This volume is the first of its kind to present a comprehensive assessment of the health sector in Afghanistan. Although health outcomes here are some of the worst in the world, the sector has made considerable progress since 2001. A nationwide survey conducted in late 2006 found that the infant mortality rate had fallen from 165 to 129 per 1,000 live births, and the under-five mortality rate had fallen from 257 to 191 per 1,000 live births. These figures represent a 22 percent and a 26 percent decline, respectively, from the end of 2001. Similarly, coverage of prenatal care has increased from less than 5 percent to 32 percent, and childhood vaccinations of DPT3 (diphtheria, pertussis, and tetanus) have increased from less than 20 percent to 35 percent between 2003 and 2006. Administrative data indicate that the number of functioning primary health care facilities has nearly doubled, from 498 in 2001 to more than 936 in 2008. Also, the quality of care in publicly financed facilities has increased by about 22 percent from 2004 to 2006. Although this progress is encouraging, it is not sufficient to ensure that Afghanistan will achieve the Millennium Development Goals (MDGs). 'Building on Early Gains in Afghanistan's Health, Nutrition, and Population Sector' presents specific policy options for Afghanistan's Ministry of Public Health to consider in advancing to the next level of care for its population. The guiding principles of these options are consistency with the ministry's vision and the feasibility of implementation. The specific challenges include revising the content of the basic package of health services (BPHS), rethinking the delivery of the BPHS, securing sustained and predictable financing, defining the role of the emerging private sector, addressing the shortage of human resources for health, and expanding the capacity of the ministry to enable it to effectively carry out its stewardship functions. This book was prepared as a resource for policy makers, practitioners, and researchers in Afghanistan and other conflict-affected countries. It emphasizes the policy implications of the findings presented.
