Health and the SDGs 2021: Afghanistan

Health and the SDGs Afghanistan Selected determinants of health Population living in urban areas (%) ( 2020) 25.0 Annual GDP growth (%) ( 2021) -20.7 Population growth rate (%) ( 2020) 2.1 Children aged < 5 years with pneumonia symptoms taken to a health care provider (%) ( 2018) 68.0 Universal health coverage UHC service coverage index (2021) 41.0 Primary health care facilities per 10 000 population ( 2019) 1.2 Hospital beds per 10 000 population ( 2019) 4.0 Demand for family planning satisfied with modern methods (%) ( 2021) 46.5 Antenatal care visits (4+ visits) ( 2018) 20.9 Measles immunization coverage among 1-year olds (%) ( 2021) 63.0 Tuberculosis treatment coverage rate (2021) 66.0 DTP3-containing vaccine/pentavalent coverage among 1-year olds (%) ( 2021) 66.0 Out-of-pocket expenditure as percentage of current health expenditure ( 2018) 78.0 Domestic general government health expenditure as % of general government expenditure ( 2018) 2.0 Neonatal, infant and under-5 mortality rates per 1000 live births Distribution of causes of death among children aged < 5 years (%) Pneumonia (ALRI), 15.2% Prematurity, 19.5% Birth asphyxia/trauma, 16.1%Sepsis & other infec�ons, 8.6% Congenital anomalies, 6.5% Diarrhoea, 7.9% Malaria, 0.1% Measles, 1.8% HIV/AIDS, 0.0% Meningi�s/encephali�s, 3.5% Injuries, 5.9% Others, 14.9% Top 10 causes of death for both sexes and all ages (2019) 0 20 40 60 80 100 120 Road injury Kidney diseases Maternal conditions Hypertensive heart disease Tuberculosis Lower respiratory infections Stroke Collective violence and legal intervention Neonatal conditions Ischaemic heart disease Deaths per 100 000 population Communicable, maternal, perinatal and nutritional conditions Noncommunicable diseases Injuries 0 50 100 150 200 250 300 2000 2005 2010 2015 2020 Ra te p er 1 00 0 liv e bi rt hs Neonatal mortality Infant mortality Under-5 mortalitySource: UN-IGME 2021 W H O -E M /H ST /2 48 /E Net primary school enrolment ratio per 100 school-age children (2017) Total ratio 56 Male ratio 66 Female ratio 46 Literacy rate (15–24 years) (2017) (%) Total 54 Male 68 Female 39 Population below the international poverty line (%) … Proportion of employed population below the international poverty line 15+ (%) (ILO modelled estimate, 2019) Male 38.0 Female 46.6 Children under 5 (%) who are: stunted 36.6 wasted 5.0 overweight 4.0 (2018) Population with primary reliance on clean fuels and technologies at the household level (%) 33.2 (WHO Global Health Observatory, 2020) Proportion of population using safely managed drinking water services (%) (World Health Statistics, 2020) 28 Proportion of population using safely managed sanitation services (%) (World Health Statistics, 2020) … Unemployment rate (15+ years) (%) (ILO estimate, 2021) Total 5.6 Male 5.6 Female 5.5 Concentrations of fine particulate matter (PM2.5) (μg/m3) (WHO Global Health Observatory, 2019) Total 62.5 Urban 75.1 Estimates of rate of homicides (per 100 000 population) (WHO Global Health Observatory, 2019) 8.5 Selected health-related SDG indicators Indicator Male Female Total Life expectancy at birth in years (2019) 63.3 63.2 63.2 Healthy life expectancy (HALE) at birth (years) (2019) 54.7 53.2 54.0 Healthy life expectancy (HALE) at 60 (years) (2019) 11.2 10.6 10.8 Maternal mortality ratio (deaths per 100 000 live births) (UN-MMEIG 2020 estimate) — — 620.0 Neonatal mortality rate (deaths per 1000 live births) (UN-IGME 2021 estimate) … … 34.0 Infant mortality rate (deaths per 1000 live births) (UN-IGME 2021 estimate) 46.5 40.1 43.4 Under-5 mortality rate (deaths per 1000 live births) (UN-IGME 2021 estimate) 59.1 52.1 55.6 Tobacco use among persons 15+ years (%) (2019) 40.7 7.7 24.2 Overweight (18+ years) (%) ( 2018) … … 25.8 Obesity (18+ years) (%) ( 2018) … … 17.0 Raised blood pressure among persons 18+ years (%) ( 2018) … … 17.7 Raised blood glucose among persons 18+ years (%) ( 2018) … … 9.2 Raised cholesterol among persons 18+ years (%) (2018) 12.0 24.7 18.1 Mortality between exact ages 30 and 70 from cardiovascular disease, cancer, diabetes or chronic respiratory disease (%) ( 2019) 34.4 36.2 35.3 Cancer incidence per 100 000 ( 2021) 107.7 111.9 108.2 Key health indicators Universal health coverage (UHC) means provision of quality services to everybody without discrimination of any kind and without exposing people to financial hardship. UHC is one of the targets of SDG 3, and attaining UHC will also contribute directly or indirectly to achieving the other SDGs. Achieving UHC means ensuring healthy lives and promoting well-being for all at all ages with explicit affirmative action for vulnerable populations including refugees and migrants. Thus, disaggregated data will be necessary to assess and address inequities in health. UHC requires intersectoral action. All countries can and must advance towards UHC by 2030, if not earlier. 3. 1. 1 M at er na l m or ta lity ra tio 3. 1. 2 Sk ille d bir th a tte nd an ce 3. 2. 1 Un de r-5 m or ta lity ra te p er 1 00 0 liv e bir th s 3. 2. 2 Ne on at al m or ta lity ra te p er 1 00 0 liv e bir th s 3. 3. 1 Nu m be r o f n ew H IV in fe cti on s 3. 3. 2 TB in cid en ce 3. 3. 3 M ala ria in cid en ce (p er 1 00 0 po pu lat ion a t r isk ) 3. 3. 4 He pa titi s B vi ru s p re va len ce a m on g ch ild re n un de r 5 ye ar s 3. 3. 5 Nu m be r o f p eo ple re qu irin g int er ve nt ion s a ga ins t le ish m an ias is 3.4 .1 Pr ob ab ility of dy ing be tw ee n a ge 30 an d e xa ct ag e 7 0 f rom C VD , c an ce r, d iab ete s, CR D 3. 4. 2 Su ici de m or ta lity ra te (d ea th s p er 1 00 0 00 p op ula tio n) 3. 5. 2 Al co ho l c on su m pt ion p er ca pit a (a ge d 15 ye ar s a nd o lde r) 3. 6. 1 D ea th ra te fr om ro ad tr af fic in ju rie s pe r 1 00 0 00 3. 7. 1 D em an d fo r f am ily p la nn in g sa tis fie d w ith m od er n m et ho ds 3. 7. 2 A do le sc en t f er til ity (1 5− 19 y ea rs ) r at e (p er 1 00 0 gi rls ) 3. 8. 1 UH C se rv ice co ve ra ge in de x 3. 8. 2 La rg e ex pe nd itu re s o n he alt h as a sh ar e of to ta l h ou se ho ld ex pe nd itu re (> 10 % ) 3. 9. 1 M or ta lit y ra te a ttr ib ut ed to h ou se ho ld a nd a m bi en t a ir po llu tio n 3. 9. 2 M or ta lit y ra te a ttr ib ut ed to u ns af e w at er , u ns af e sa ni ta tio n an d la ck o f h yg ie ne 3. 9. 3 M or ta lit y ra te a ttr ib ut ed to u ni nt en tio na l p oi so ni ng s 3. a. 1 To ba cc o us e (a ge d 15 ye ar s a nd o lde r) (% ) 3. b. 1 Va cc ine co ve ra ge (D TP 3) 3. b. 1 Va cc ine co ve ra ge (M CV 2) 3. b. 1 Va cc ine co ve ra ge (P CV 3) 3. b. 2 To ta l n et O DA to m ed ica l r es ea rc h 3. b. 3 Av ail ab ilit y o f s ele cte d es se nt ial m ed ici ne s ( pu bli c h ea lth fa cil itie s) (% ) 3. c.1 P hy sic ian s p er 1 0 00 0 po pu lat ion 3. c.1 N ur sin g an d m idw ife ry p er 1 0 00 0 po pu lat ion 3. c.1 P ha rm ac ist s p er 1 0 00 0 po pu lat ion 3. c.1 D en tis ts pe r 1 0 00 0 po pu lat ion 3. d. 1 IH R an nu al re po rti ng 3. d. 2 Pe rc en ta ge o f b loo ds tre am in fe cti on s d ue to E SB L- E. co li 3. d. 2 Pe rc en ta ge o f b loo ds tre am in fe cti on s d ue to M RS A Yemen United Arab Emirates Tunisia Syrian Arab Republic Sudan Somalia Saudi Arabia Qatar Pakistan Oman Occupied Palestinian territory Morocco Libya Lebanon Kuwait Jordan Iraq Iran, Islamic Republic of Egypt Djibouti Bahrain Afghanistan No d at a On e da ta p oin t At le as t t wo d at a po int s No t a pp lic ab le Source: Progress on the health-related Sustainable Development Goals and targets in the Eastern Mediterranean Region, 2020. Cairo: WHO Regional Office for the Eastern Mediterranean; 2022. Availability of data for each SDG 3 indicator: no data, one and at least two data points, 2014–2019 Developed jointly by: Department of Science, Information and Dissemination Chef de Cabinet office © World Health Organization 2023 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons. org/licenses/by-nc-sa/3.0/igo). Health and the SDGs at a glance in Afghanistan Voluntary National Review Completed in 2021: https://hlpf.un.org/countries/afghanistan National Focal Point for 2030 Agenda at WHO country office Dr Abdul Ghani Ibrahimi, Acting Programme Manager, Health System WHO country office National Focal Point in the Ministry of Health for health-related SDGs Dr Mirwais Ahmadzai, Director-General, Policy and Planning, Ministry of Public Health 1. Summarize efforts at the national level in setting targets for health-related SDGs. • Adaptation of SDG targets and indicators, including for SDG 3, taking into account the country’s specific context and circumstances, through a consultative process involving governmental agencies, civil society, the private sector, academia, international development partners, Kabul-based United Nations (UN) agencies, women and youth. • Prioritization of A-SDGs’ goals and targets based on evidence- based analysis and data modeling. • Establishment of a technical working group on SDG 3 in the Ministry of Public Health with membership from different stakeholders, including WHO. • Review of the health sector indicators by related departments of the Ministry of Public Health and revision of baselines and indicators. • Identification of strategic interventions and projects for implementation under each indicator. • Identification of the programmes and projects available for implementation under each indicator. • Identification of areas of vulnerability and priority areas for the SDGs. • Development of the baseline and targets for SDG 3 until 2030. 2. How is Afghanistan incorporating SDG 3 targets in health policy, strategy and planning? The national health policy 2021–2030, recently developed with the support of WHO, builds on the SDGs. The policy aims to improve the health of all Afghans in line with SDG 3 by responding to health needs in a timely and effective manner. 3. Are there any major partnerships for advancing the health-related SDGs? Since the 2021 political changes in the country, a new framework called the Transitional Engagement Framework 2022 has replaced the UN-level Cooperation Framework. UN agencies and their partners in the country are currently developing the Health Sector Transitional Strategy 2023–2025 to minimize avoidable morbidity and mortality by expanding the coverage of quality health and nutrition services and strengthen health system resilience. 4. Describe a success story or an opportunity for strengthening the health system for COVID-19 that supports efforts towards achieving one or more of the SDG health-related targets. Despite increased support for different areas during the COVID-19 pandemic, including maintaining essential services, surveillance and capacity-building of the health workforce, the pandemic and the recent political changes have negatively affected progress toward achieving the health-related SDGs, which was already lagging behind. The UN agencies and their partners in the country are developing the Health Sector Transitional Strategy 2023–2025. The strategy aims to: 1) strengthen and expand essential service coverage/utilization and quality of care and improve financial risk protection for the most vulnerable groups; 2) sustain and strengthen essential foundations of the health system necessary for meeting basic human health needs; 3) strengthen capacities to prevent, detect and respond to disease outbreaks and other health emergencies; and 4) strengthen harmonization and alignment of financing toward national health priorities to increase predictability, adaptability and efficiency of funding.