Programme

Health

Ending preventable maternal, newborn and child deaths

UNICEF Afghanistan/2020/Omid Fazel

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Challenge

No child or mother should suffer and die from preventable causes. Yet, Afghanistan remains one of the most dangerous places in the world to be a baby, a child or a mother, and access to a hospital or health facility is beyond the reach of most. The country has one of the highest infant mortality rates in the world and thousands of Afghan women die every year from pregnancy-related causes, a majority of which can be easily preventable.

Although present conditions are improving, and many more children are living past infancy, in 2018, 4 out of 10 Afghan children died before their first birthday. While this is a significant drop since 1990, far too many families are unnecessarily losing their children, especially during the neonatal period. The majority of these deaths can be prevented with timely and adequate care, and treatment, as well as healthy beahviours.

Children and mothers need access to quality community-based healthcare and comprehensive emergency obstetric and newborn care at district and provincial hospitals. This is critical in the first days of a child’s life and during a mother’s labour and delivery, particularly for women who have complicated pregnancies. Up to the age of five, and especially in the first weeks and months of a child’s life, protection against preventable illnesses is critical. Low immunization levels among poor and marginalized children compromise gains made in all other areas of maternal and child health.

Adolescents (ages 10-19), who make up 40 per cent of the population in Afghanistan, face tremendous challenges in meeting their sexual reproductive health needs. Despite advances in gender equality over the last decade, and according to the 2020 Human Development Report, Afghanistan ranks 169 on the Gender Inequality Index (GII) - among the least favorable scores, reflecting high levels of inequality in reproductive health, women’s empowerment, and economic activity. This affects their ability to reach their full potential and contributes to the high maternal mortality ratio of 638 per 100,000 live births.

What_we_do — UNICEF Afghanistan/2020/Dejongh

Reaching every child

Under the leadership of Afghanistan’s Ministry of Public Health, UNICEF works with partners to improve services and ensure quality reproductive maternal newborn child and adolescent health (RMNCAH) care, as well as expanded programme on immunization (EPI) services for children and women.

Focusing on the most vulnerable and strengthening primary health care services (PHC), with partners, UNICEF addresses the reasons these children and mothers don’t receive the health information and care they need.

A mother holds her baby as he receives a vaccine at a clinic in Badakhshan, northeastern Afghanistan. — UNICEF Afghanistan/2016/Froutan

Reproductive, maternal, newborn, and child health

As the lead United Nations agency addressing newborns’ needs, UNICEF works to expand services in existing health facilities and reach mothers and children in remote villages. UNICEF strengthens health facilities by providing training and essential newborn care equipment, deploying mobile health outreach teams to isolated areas, and supporting specialized maternity ‘waiting homes and rooms.’

At the national level, UNICEF supports the Ministry of Public Health in the development and roll-out of standardized national guidelines for community-based newborn care. This includes the provision of impactful intervention such as zinc and oral rehydration solution co-packs for treatment of diarrhea at community level.

Global COVID-19 pandemic reveals increased needs for primary health care strengthening, which requires support to scaleup community-based healthcare. UNICEF continues to advocate for a multi-sectoral approach that strengthens primary health care (PHC) particularly at community level. This entails supporting the Government to develop the costed national community health roadmap and promoting integrated package of community health services that include essential health care, nutrition, hygiene promotion, polio, and child protection.

Adolescent health

UNICEF supports the Ministry of Public Health to address service gaps of adolescent sexual and reproductive health interventions and information through establishment of youth-friendly, gender-sensitive services. UNICEF puts adolescent health including adolescent mothers and their newborns at the forefront in addressing high maternal, and newborn mortalities and stillbirth.

Routine immunization

UNICEF is proud to work with the Ministry of Public Health, implementing partners and communities to immunize every child with life-saving vaccines against nine dangerous diseases, reaching the hardest to reach children. UNICEF supports the Government to plan, build the capacity of mobilizers, vaccinators and programme managers, raise awareness, procure and distribute quality vaccines to children and eligible women, and make sure they are viable until administered.

As the world's largest single vaccine buyer, UNICEF supports the Government to procure vaccines, and maintain the ‘cold chain’ system that includes storage equipment and refrigerators across the country,

even in mountainous and difficult terrains, to guarantee that the vaccines retain their potency and are effective in preventing diseases. As part of COVAX facility, UNICEF works with major donors to ensure COVID-19 vaccines are equitably distributed and delivered to the intended populations.

While supporting the Ministry of Public Health’s national immunization process from beginning to end, UNICEF works towards building the capacities of the local communities and health care providers for a sustainable future. UNICEF provides technical assistance to introduce new vaccines nationally as they are approved.

Under the leadership of the Ministry of Public Health, and in collaboration with the World Health Organization (WHO), UNICEF continues its efforts to eradicate poliomyelitis from Afghanistan.

Health emergency preparedness and response

Under the leadership of the Ministry of Public Health and in coordination with the Health Cluster, UNICEF prepares and responds to health emergencies. UNICEF supports the Government to respond to COVID-19 crisis through the procurement and supply of essential equipment and medicines and risk communication and community engagement (RCCE) initiatives.

The power of information

Health-systems strengthening efforts can be less visible, but they are essential for the progress of public health. One of the most effective ways is to support the Ministry of Public Health at the national and provincial levels to effectively gather and analyse data and transform it into information and evidence. During COVID-19 pandemic, UNICEF supports the Ministry of Public Health to monitor access to essential health services using RMNCH scorecard and monitoring tool.

Data strengthening, research and evaluation work-centred on children’s, newborns’ and women’s health can influence national policies and programmes. It encourages focus on the needs of the most vulnerable populations and influences policies in their support. It also mobilises resources to health programmes, particularly in the often-neglected area of newborn health and investment of community-based health care.

Infographic outlining maternal, newborn, and child health strategies — UNICEF Afghanistan

The health programme in numbers

On a yearly basis, nearly 1.2 million children under one year receive life-saving vaccines.
On a yearly basis, 6 million pregnant women receive vaccines that prevent nine diseases.
In 2020, 50,364 pregnant women and 79,362 children who live more than two hours away from a health facility received essential health care through mobile health teams.