Healthcare for Overburdened Communities

Since 2016, more than 1.6 million Afghan nationals who had fled from armed conflict and violence to Pakistan and Iran have returned to their homeland. Many of them are destitute and cannot resettle in their former home. In the province of Kabul alone, around 170,000 people sought refuge in 2016 and 2017, due to the comparatively good security situation and better income opportunities.

Context

However, there is insufficient capacity to accommodate newcomers. The influx of returning refugees is an additional burden on the already inadequate infrastructure of Kabul and other host communities. Basic social services in health and education, accommodation, and access to food, water and sanitation are scarce. The pressure on the job market is also high. This can lead to increased tensions between host communities and returnees.

The government cannot resolve these problems alone. Especially in the area of basic health services, there is a great need for assistance. Diarrhoeal and skin diseases, flu infections, gynaecological problems and hepatitis B and C are commonplace. In many places, however, hardly any health services are available to the population. People are forced to travel long distances for medical care. This situation is particularly threatening to women, who for cultural reasons are very restricted in their mobility.

Objective

Basic medical care for returnees, internally displaced people and the local population of host communities is guaranteed by the rehabilitation and operation of two health centres in Walayati (Bagrami district) and Bazari (Kalakan district) in Kabul province. Mothers and children in particular benefit from the health services.

Measures and Results

To provide returnees, internally displaced people and the local population in the host communities of the province of Kabul with access to basic medical care, the German government is supporting the rehabilitation and operation of two existing health centres in Walayati and Bazari. The goal is to improve the health situation for around 30,000 people in the districts of Bagrami and Kalakan, around 2,700 of whom are returnees.

Basic healthcare

The rehabilitation and operation of two health centres will contribute to ensuring that people in Walayati and Bazari have secure access to basic health services. The aim is to ensure there is enough personnel, equipment and medication to provide basic medical treatment, vaccinations and health services for mothers and children. The health centres will employ two doctors, two nurses, two community midwives, two vaccine workers and two community health supervisors. The staff undergoes regular training to ensure quality healthcare. So far, the project has delivered training to more than 10 employees of the health centres, while 65 community health workers, community health supervisors and volunteers have also received training.

Health services for mothers and children

Until now, the health centres have not taken the concerns of mothers and children sufficiently into account. Special attention is therefore paid to health services for this particularly vulnerable target group. The health centres provide pre- and postnatal care for pregnant women as well as obstetric care and vaccinations for children under a year old. Awareness and information campaigns advise mothers on feeding infants and young children. Another aim is to increase the proportion of women who give birth under the supervision of a qualified midwife to 80 per cent.

Local structures for health

To improve the health situation sustainably in the communities, two local health committees (shuras) have been established. These promote the dissemination of health information among the villagers of Walayati and Bazari. Around 1,600 awareness-raising events are contributing to further improvements in the health situation at community level. A total of around 12,800 people have benefited from information campaigns about the available health services and have been informed about good hygienic practices, and the care for pregnant women, mothers who have recently given birth, infants and young children.

At a glance

Programme:
Basic medical care for returnees, internally displaced people and host communities in the province of Kabul
Commissioned by:
German Federal Foreign Office (AA)
Partner:
Malteser International
Implementing organisations:
UnionAid
Provinces:
Kabul
Programme objective:
To ensure the rehabilitation and operation of two health centres to guarantee primary healthcare in the districts of Bagrami and Kalakan
Overall term:
September 2018 – October 2020