HeRAMS Afghanistan Status Update Report January 2023-Communicable disease services（英文）行业资料

HeRAMSAfghanistan

StatusUpdateReport

January2023

serviCes

CommuniCabledisease

Acomprehensivemapping

ofavailabilityofessential

servicesandbarrierstotheir

provision

©WorldHealthOrganization2023

Somerightsreserved.ThisworkisavailableundertheCreativeCommonsAttribution-NonCommercial-ShareAlike3.0IGOlicence(CCBY-NC-SA3.0IGO;/licenses/by-nc-sa/3.0/igo).

Underthetermsofthislicence,youmaycopy,redistributeandadapttheworkfornon-commercialpurposes,providedtheworkisap-propriatelycited,asindicatedbelow.Inanyuseofthiswork,thereshouldbenosuggestionthatWHOendorsesanyspecificorganization,productsorservices.TheuseoftheWHOlogoisnotpermitted.Ifyouadaptthework,thenyoumustlicenseyourworkunderthesameorequivalentCreativeCommonslicence.Ifyoucreateatranslationofthiswork,youshouldaddthefollowingdisclaimeralongwiththesuggestedcitation:

“ThistranslationwasnotcreatedbytheWorldHealthOrganization(WHO).WHOisnotresponsibleforthecontentoraccuracyofthistrans-lation.TheoriginalEnglisheditionshallbethebindingandauthenticedition”.

AnymediationrelatingtodisputesarisingunderthelicenceshallbeconductedinaccordancewiththemediationrulesoftheWorldIntel-lectualPropertyOrganization(/amc/en/mediation/rules/).

Suggestedcitation.HeRAMSAfghanistanStatusUpdateReportJanuary2023-Communicablediseaseservices:Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision;2023

Third-partymaterials.Ifyouwishtoreusematerialfromthisworkthatisattributedtoathirdparty,suchastables,figuresorimages,itisyourresponsibilitytodeterminewhetherpermissionisneededforthatreuseandtoobtainpermissionfromthecopyrightholder.Theriskofclaimsresultingfrominfringementofanythird-party-ownedcomponentintheworkrestssolelywiththeuser.

Generaldisclaimers.ThedesignationsemployedandthepresentationofthematerialinthispublicationdonotimplytheexpressionofanyopinionwhatsoeveronthepartofWHOconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement.

Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimplythattheyareendorsedorrecommendedbyWHOinpreferencetoothersofasimilarnaturethatarenotmentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistinguishedbyinitialcapitalletters.

AllreasonableprecautionshavebeentakenbyWHOtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallWHObeliablefordamagesarisingfromitsuse.

HeRAMSAfgHAniStAn

StAtuSupdAteRepoRt

JAnuARy2023

Communicablediseaseservices

Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision

Contributors

tableofContent

Acronyms2

Disclaimer3

Overviewofevaluatedhealthfacilities4

Part1:AvailabilityofNCDandmentalhealthservices5

Interpretationguide6

Overviewofserviceavailability7

Overviewofmainbarriersimpedingserviceavailability8

Serviceavailabilitypercatchmentpopulation9

Overviewofmainbarriersbyservice11

Part2:In-depthanalysisbyhealthservice15

Interpretationguide18

Syndromicsurveillance20

Event-basedsurveillance22

DiagnosisofmalariawithRDT24

Diagnosisandtreatmentofmalaria26

Supportmassdrugadministration28

Supportvectorcontrolinterventions30

DiagnosisandtreatmentofTB32

MDRTB34

IEConpreventionofprioritydiseases36

Otherlocallyrelevantdiseases38

Managementofseverecommunicablediseases40

Annex43

AnnexI:HeRAMSservicedefinitions44

AnnexII:Populationestimates45

HeRAMSAfghanistanStatusUpdateReportJanuary2023

2

aCronyms

BHC

BasicHealthCenter

CHC

ComprehensiveHealthCenter

DH

DistrictHospital

FATP

FirstAidTraumaPost

FHH

FamilyHealthHouse

HeRAMS

HealthResourcesandServicesAvailabilityMonitoringSystem

ICE

Information,EducationandCommunication

MDRTB

Multidrug-resistantTuberculosis

MHT

MobileHealthTeam

NH

NationalHospital

PH

ProvincialHospital

RDT

RapidDiagnosticTest

RH

RegionalHospital

SHC

SubHealthCenter

TB

Tuberculosis

WHO

WorldHealthOrganization

CommunicableDiseasesServices

Disclaimer

Disruptionstohealthsystemscanimpedeprovisionofandaccesstoessentialhealthservices.Communities’vulnerabilitytoincreasedmorbidityandmortalitysubstantiallyincreaseswhenalackofreliableinformationpreventssounddecision-making,especiallyinrapidlychangingenvironmentsrequiringcontinuedassessment.TheHealthResourcesandServicesAvailabilityMonitoringSystem(HeRAMS)aimstoprovidedecision-makersandhealthstakeholdersatlargewithvitalandup-to-dateinformationontheavailabilityofessentialhealthresourcesandservices,helpthemidentifygapsanddetermineprioritiesforintervention.

HeRAMSdrawsonthewealthofexperienceandknowledgegatheredbytheWorldHealthOrganization(WHO)andhealthsectoractors,includingnongovernmentalorganizations(NGOs),donors,academicinstitutionsandothertechnicalbodies.Itbuildsonacollaborativeapproachinvolvinghealthserviceprovidersatlargeandintegratingwhatismethodologicallysoundandfeasibleinhighlyconstrained,low-resourcedandrapidlychangingenvironmentssuchashumanitarianemergencies.Rapidlydeployableandscalabletosupportemergencyresponseandfragilestates,HeRAMScanalsobeexpandedto-ordirectlyimplementedas-anessentialcomponentofroutinehealthinformationsystems.Itsmodularityandscalabilitymakeitanessentialcomponentofemergencypreparednessandresponse,healthsystemsstrengthening,universalhealthcoverageandthehumanitariandevelopmentnexus.

HeRAMShasbeendeployedinAfghanistansinceNovember2021.1Thisanalysispresentstheresultsoftheassessmentof3884healthfacilitiesacrossthecountry,againstestimatedtotalof4238healthfacilities,andisbasedondatareportedasofJanuary18th,2023.WhilethedeploymentofHeRAMSremainsongoinganddataverificationandvalidationcontinue,theanalysispresentedhereisnotfinalandhasbeenproducedsolelytoinformoperations.

ThisisthefourthreportoftheHeRAMSAfghanistanStatusUpdateReportJanuary2023seriesfocusingontheavailabilityofcommunicablediseaseservices.Itisacontinuationofthefirstreportontheoperationalstatusofthehealthsystem2andshouldalwaysbeinterpretedinconjunctionwithresultspresentedinthefirstreport.Additionalreportsareavailablecoveringessentialclinicalandtraumacareservices3,childhealthandnutritionservices4,sexualandreproductivehealthservices5,andnon-communicablediseaseandmentalhealthservices6.

Cautionmustbetakenwheninterpretingtheresultspresentedinthisreport.DifferencesbetweeninformationproductspublishedbyWHO,nationalpublichealthauthorities,andothersourcesusingdifferentinclusioncriteriaanddifferentdatacut-offtimesaretobeexpected.Whilestepsaretakentoensureaccuracyandreliability,alldataaresubjecttocontinuousverificationandchange.

Foradditionalinformation,pleasesee/initiatives/heramsorcontactherams@

1HeRAMSAfghanistanBaselineReport-Operationalstatusofthehealthsystem:Acomprehensivemappingoftheoperationalstatushealthfacilities,/publications/m/item/herams-afghanistan-baseline-report-2022-operational-status-of-the-health-system.

2HeRAMSAfghanistanStatusUpdateReportJanuary2023-Operationalstatusofthehealthsystem:Acomprehensivemappingoftheoperationalstatushealthfacilities,

/publications/m/item/herams-afghanistan-status-update-report-2023-01-operational-status-of-the-

health-system

.

3HeRAMSAfghanistanStatusUpdateReportJanuary2023-Generalclinicalandtraumacareservices:Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision,

/publications/m/item/

herams-afghanistan-status-update-report-2023-01-general-clinical-and-trauma-care-services.

4HeRAMSAfghanistanStatusUpdateReportJanuary2023-Childhealthandnutritionservices:Acomprehensivemappingofavailabilityofessentialservicesbarrierstotheirprovision,

/publications/m/item/herams-afghanistan-status-update-report-2023-01-child-

health-and-nutrition-services

.

5HeRAMSAfghanistanStatusUpdateReportJanuary2023-Sexualandreproductivehealthservices:Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision,

/publications/m/item/herams-afghanistan-status-update-report-2023-01-

sexual-and-reproductive-health-services

.

6HeRAMSAfghanistanStatusUpdateReportJanuary2023-Non-communicablediseaseandmentalhealthservices:Acomprehensivemappingofavailabilityofessentialservicesandbarrierstotheirprovision.

/publications/m/item/herams-afghanistan-status-update-report-

2023-01-ncd-and-mental-health-services

.

3

Numberofhealthfacilities

HeRAMSAfghanistanStatusUpdateReportJanuary2023

OverviewOfhealthfacilitiesevaluateD

Summaryofhealthfacilitiesevaluated

Numberofhealthfacilities

Recentnessofhealthfacilityupd5750002500NovDecJanFeabMarAprMayJunJulMostrecentdateofupdattSepOctNovDecJaesn

750

500

250

0

Feb2022

Jul2022

Sep2022

Nov2021

Dec2021

Jan2022

Mar2022

Apr2022

May2022

Jun2022

Aug2022

Nov2022

Dec2022

Jan2023

Oct

2022

Mostrecentdateofupdate

OperationalNotoperationalPlannedClosed

4

Parti:

availabilityOfcOmmunicableDiseaseservices

HeRAMSAfghanistanStatusUpdateReportJanuary2023

6

Barrier1

Barrier2

Barrier3

Barrier4

Barrier5

Region

Forservicesnotoronlypartiallyavailable,mainbarriersimpedingservicedeliveryaredisplayedaspercentageofallbarriersreported.Alikeforserviceavailability,barchartsdisplaymainbarriersdisaggregatedbyhealthfacilitytypeandregionwiththenumberhealthfacilitiesreportingatleastonebarrierindicatedbelowthehealthfacilitytypename.Notethatforeachservice,uptothreebarrierscouldbereported.Hence,thepercentagesshowninthesechartsshouldnotbeusedtomakeanyconclusionthepercentageofhealthfacilitieshavingreportedabarrier.

interpretatiOnguiDe

Serviceavailability

Thefirstpartofthereportprovidesanoverviewofavailabilityofcommunicablediseaseservices.Itshouldbenotedthattheanalysiswaslimitedtooperationalhealthfacilities.Asummaryofhealthfacilitiesevaluatedandtheiropera-tionalstatusisavailableonpage4.FurtherdetailsontheoperationalstatusofhealthfacilitiescanbefoundinthefirstreportoftheHeRAMSAfghanistanStatusUpdateReport2023series.

Barchart

Overallavailabilityofgeneralclinicalandtraumacareservicesisshowndisaggregatedby

regionandhealthfacilitytype.Thenumberofhealthfacilitiesincludedisdisplayedbelow

thehealthfacilitytypename.

Itshouldbenotedthatthenumberofservicesincludedwaslimitedtohealthservices

expectedbasedonnationalguidelinesanddependsonthetypeofhealthfacility.Further

detailsonservicesincludedforeachtypeofhealthfacilitiesisshownin

annexI

.

Serviceavailabilityperpopulation(heatmap)

Service1

Service2

Service3

Service4

Service5

0.9

0

0.4

2.1

0.7

0.4

0

0.9

3.5

0.7

0.3

0

0.7

0.3

0.2

0.8

0

0.4

0.8

0.6

0.5

0

0.9

1.9

0.8

ProvinceA

ProvinceB

ProvinceC

ProvinceD

ProvnceE

Amoredetailedoverviewofavailabilityofindividualservicesisshownasheatmaps.Eachcellindicatesthenumberofhealthfacilitiesprovidingagivenserviceinrelationtothecatchmentpopulation.Itshouldbenotedthatdifferentcatchmentareaswereusedforreferralandspecializedhealthservices.Formoredetailsonpopulationestimates,see

annexII

.

Toaccountforpartiallyavailableservices,aweighingwasappliedwithaweightof1giventoservicesreportedasfullyavailableand0.5forpartiallyavailableservices.

Mainbarriersimpedingserviceavailability

Barchart

Region

Heatmap

Heatmapsprovideadditionalinsightsonmainbarriersforeachservicesbycatchmentarea.Cellopacitylevelsindicatethepercentageofhealthfacilitiesinthecatchmentareahavingreportedagivenbarriers.Theintegerinsidethecelldenotesthenumberofhealthfacili-tieshavingreportedgivenbarrierwhilethepercentageindicatesthepercentageofhealthfacilitiesreportingthebarrier.Notethathealthfacilitiesnotreportingabarrier(i.e.healthfacilitieswheretheserviceisfullyavailableornotnormallyprovided)wereexcludedfromthesecharts.

Service1

Service2

Service3

Service4

Service5

2

20%

880%

550%

1

10%

550%

660%

2

20%

1

10%

550%

7

70%

8

80%

4

40%

440%

220%

3

30%

7

70%

1

10%

550%

1

10%

3

30%

2

20%

330%

NH

(n=21)

RH

(n=7)

PH

(n=5)

DH

(n=24)

CHC

(n=98)

BHC

(n=198)

SHC

(n=139)

MHT

(n=59)

FHH

(n=8)

Other

(n=37)

NH

(n=4)

RH

(n=1)

PH

(n=5)

DH

(n=11)

CHC

(n=44)

BHC

(n=137)

SHC

(n=148)

MHT

(n=108)

FHH

(n=18)

Other

(n=18)

NH

(n=2)

RH

(n=1)

PH

(n=4)

DH

(n=16)

CHC

(n=51)

BHC

(n=136)

SHC

(n=168)

MHT

(n=40)

FHH

(n=40)

Other

(n=18)

NH

(n=1)

PH

(n=3)

DH

(n=6)

CHC

(n=62)

BHC

(n=128)

SHC

(n=216)

MHT

(n=96)

Other

(n=10)

PH

(n=2)

DH

(n=6)

CHC

(n=19)

BHC

(n=40)

SHC

(n=72)

MHT

(n=20)

FHH

(n=83)

Other

(n=4)

RH

(n=1)

PH

(n=3)

DH

(n=10)

CHC

(n=59)

BHC

(n=141)

SHC

(n=184)

MHT

(n=47)

FHH

(n=10)

Other

(n=23)

NH

(n=1)

RH

(n=3)

PH

(n=3)

DH

(n=9)

CHC

(n=56)

BHC

(n=95)

SHC

(n=146)

MHT

(n=40)

FHH

(n=20)

Other

(n=19)

RH

(n=1)

PH

(n=3)

DH

(n=12)

CHC

(n=52)

BHC

(n=104)

SHC

(n=158)

MHT

(n=76)

FHH

(n=91)

Other

(n=31)

29%

14%

25%29%

47%

61%

CommunicableDiseasesServices

OverviewOfserviceavailability

Availabilityofessentialhealthservicesbyregionandhealthfacilitytype7

100%

75%

50%

25%

0%

100%

75%

50%

25%

0%

100%

75%

50%

25%

0%

100%

75%

50%

25%

0%

Capital

68%

67%

14%

30%

4%

86%

64%

35%

47%

5%

68%

70%

98%

92%

4%

29%

29%

60%

50%

6%

31%

23%

7%

Eastern

14%

14%

75%

71%

8%

17%

17%

29%

83%

66%

18%

41%

63%

81%

19%

56%

35%

20%

80%

100%

3%

15%

59%

Northern

94%

86%

71%74%

6%

71%

50%

36%

83%

94%93%

4%

4%5%

11%

Southern

29%

5%

100%

67%

8%

4%

88%

11%

35%

46%

64%

89%

61%3%

52%

30%

51%

13%

6%

30%

CentralHighland

19%

100%

81%

19%

40%44%

80%

60%56%

69%

8%

21%

30%

19%

50%

89%

11%

NorthEastern

20%

29%

40%

54%

72%

4%

100%

27%

71%

6%

52%

43%

27%

14%

10%

28%

44%

25%

77%

76%

72%

SouthEastern

10%

19%

12%11%

30%

50%

78%

90%

81%

88%

67%

74%

96%

85%

70%

3%

50%

27%

11%

11%

25%

4%

Western

10%

41%

11%

63%

70%

11%

90%

17%

68%

16%

5%

11%

11%

4%

24%

15%

5%

3%

11%

86%

62%

23%

47%

31%

33%

38%

38%

34%

14%

AvailablePartiallyavailableNotavailableNotnormallyprovided

7Limitedtoservicesexpectedbasedonnationalguidance.Note,thenumberofservicesincludedmayvaryfromonehealthfacilitytypetoanother.SeeannexIforacomprehensivedescriptionofservicesincludedforeachhealthfacilitytype.

7

NH

(n=11)

RH

(n=2)

DH

(n=27)

CHC

(n=60)

BHC

(n=69)

SHC

(n=24)

MHT

(n=79)

Other

(n=8)

NH

(n=9)

PH

(n=6)

RH

(n=3)

CHC

(n=9)

BHC

(n=68)

SHC

(n=54)

MHT

(n=450)

Other

(n=15)

NH

(n=2)

DH

(n=1)

CHC

(n=5)

BHC

(n=59)

SHC

(n=93)

MHT

(n=44)

FHH

(n=14)

Other

(n=5)

PH

(n=1)

DH

(n=2)

CHC

(n=5)

BHC

(n=57)

SHC

(n=66)

MHT

(n=67)

Other

(n=21)

CHC

(n=2)

BHC

(n=2)

SHC

(n=3)

MHT

(n=13)

FHH

(n=280)

PH

(n=6)

DH

(n=3)

CHC

(n=19)

BHC

(n=43)

SHC

(n=38)

MHT

(n=310)

NH

(n=4)

CHC

(n=27)

BHC

(n=3)

MHT

(n=27)

Other

(n=3)

PH

(n=6)

DH

(n=9)

CHC

(n=165)

BHC

(n=258)

SHC

(n=812)

MHT

(n=90)

FHH

(n=421)

Other

(n=142)

3%

19%

25%

41%

12%

50%

50%

100%

20%

40%

40%

30%

36%

25%

9%

29%

43%

29%

40%

20%

40%

100%

100%

40%

20%

20%

20%

30%

23%

11%

21%

16%

24%

22%

43%

7%

38%

29%

19%

5%

10%

HeRAMSAfghanistanStatusUpdateReportJanuary2023

OverviewOfmainbarriersimpeDingservice

availability

Mainbarriersimpedingavailabilityofessentialhealthservicesbyregionandhealthfacilitytype

100%

75%

50%

25%

0%

100%

75%

50%

25%

0%

100%

75%

50%

25%

0%

100%

75%

50%

25%

0%

Capital

18%

27%

10%

22%

25%

35%

100%

29%

25%

25%

30%

30%

29%

11%

22%

45%

25%

50%

58%

32%

30%

18%

12%

15%

17%

17%

19%

9%

5%

7%

Eastern

11%

26%

34%

24%

40%

26%

22%

33%

31%

27%

56%

24%

11%

11%

4%

20%

33%

33%

33%

33%

33%

30%

33%

33%

33%

33%

13%

16%

17%

17%

6%

Northern

3%

33%

29%

32%

Southern

5%

3%

27%

42%

23%

CentralHighland

15%

33%32%

50%

4%

19%

33%

85%

20%

50%

33%

24%

50%

50%

NorthEastern

17%

33%

33%

100%

17%

67%

17%

29%

17%

5%

5%

5%

100%

53%

32%

33%

32%

3%

4%

SouthEastern

11%

11%

19%

25%

33%

48%

50%

33%

11%

11%

25%

44%

33%

30%

33%

33%

33%

15%

Western

10%

23%

36%

23%

15%

13%

17%

11%

22%

24%

26%

19%

23%

12%

21%

13%

15%

16%

23%

22%

22%

25%

44%

29%

21%

29%

30%

33%

34%

33%

33%

16%

19%

17%

17%

12%

LackofstaffLackoftrainingLackofmedicalsuppliesLackofmedicalequipmentLackoffinancialresources

8

Kabul

Kapisa

Logar

Maidan

Wardak

Panjsher

Parwan

Bamyan

Daykundi

Ghazni

Khost

Paktika

Paktya

Kunar

Laghman

Nangarhar

Nuristan

Badakhshan

Baghlan

Kunduz

Takhar

Badghis

Farah

Ghor

Hirat

CommunicableDiseasesServices

serviceavailabilitybycatchmentpOpulatiOn

Numberofhealthfacilitiesprovidingessentialcommunityandprimaryservicesper10,000population8,9

Syndromicsurveillance

Eventbasedsurveillance

Malariaatthecommunity

level

Malariaattheprimary

carelevel

Vectorcontrol

Supportmassdrug

administration

Tuberculosis

IEConlocalpriority

diseasesLocalprioritydiseases

Syndromicsurveillance

Eventbasedsurveillance

Malariaatthecommunity

level

Malariaattheprimary

carelevel

Vectorcontrol

Supportmassdrug

administration

Tuberculosis

IEConlocalpriority

diseasesLocalprioritydiseases

Capital

0

0.4

0.8

0.1

0

0.2

0.1

0.3

0.9

0.1

0.1

0.8

0.5

0.5

0.8

0.5

0.3

0.9

0.6

0.5

0.9

0.7

0.3

0.9

0.1

0.4

0.8

0

0.2

0.2

0

0.2

0.4

0.1

0

0

0.3

0.4

0.1

0.3

0.3

0.3

0.5

0.2

1

0.4

0.3

1

0.4

0.2

0.6

0.3

0.3

1

Northern

0.3

0.1

0.8

0.9

0.9

0.6

0.1

0.7

0.9

0.8

0.7

0.3

0.4

0.8

0.5

0.9

0.3

0.8

0.8

0.9

0

0.1

0

0.1

0.3

0

0.1

0

0.1

0.1

0.3

0.2

0.2

0.7

0.2

0.9

0.3

0.8

0.8

0.7

0.6

0.2

0.8

0.9

0.5

Balkh

Faryab

Jawzjan

Samangan

Sar-E-Pul

Central

Highland

0.6

1

0.3

1

1.4

1.3

1.3

1.7

0.2

1.7

0.3

0.8

1.2

0.3

1.3

1.7

0.9

0.9

South

Eastern

0.3

0.5

0

0.6

0.5

0.6

0.1

0.6

0.5

0.8

0.6

0.4

0.8

0.9

0.7

0.7

0.5

0.1

0

0.2

0.5

0.4

0

0.4

0.3

0.5

0.3

0.5

0.8

0.9

0.3

0.6

0.8

0.8

0.1

0.6

Eastern

0.3

0

0.1

0.6

0.5

0.1

0.2

2.8

1

0.2

0.6

1.7

1.1

0.7

0.7

1.8

0.6

0.1

0.6

1.7

0.1

0.1

0.3

0

0.2

0.3

0.4

0.6

0.7

0.5

0.6

2.6

0.7

0.3

0.6

1.9

Southern

0.3

0.3

2.8

0.3

0.5

0.4

0.4

3

0.4

0.9

0.8

0.5

3.4

0.5

1.1

0.9

0.6

3.4

1.4

1.4

0.6

0.3

2.2

1.1

0.4

0.6

0.3

2.2

0.3

0.3

0.5

0.3

1.1

0.4

0.7

0.8

0.6

2.7

1.4

1.5

0.7

0.4

2.4

1.3

1.2

Hilmand

Kandahar

Nimroz

Uruzgan

Zabul

North

Eastern

0.7

0.1

0.2

0.1

0.8

0.3

0.7

0.2

0.9

0.7

0.4

0.5

0.9

0.7

0.7

0.8

0.7

0.3

0

0

0.6

0.4

0

0.1

0.3

0.4

0.2

0.6

0.4

0.8

0.6

0.8

0.3

0.5

0.7

0.4

Western

0.8

0.3

0.2

0.7

0.8

0.3

0.3

0.7

0.7

0.4

0.5

0.7

1.2

0.8

0.6

0.7

0.4

0.1

0.2

0.1

0.6

0.2

0.2

0.6

0.3

0.7

0.3

0.4

1.1

0.7

0.3

0.8

0.8

0.7

0.3

0.7

Serviceavailabilityper

10,000population

05>=1

8See

annexII

foranoverviewofprovincialpopulationestimates.

9Whiletheaveragenumberofhealthfacilitiesprovidingessentialhealthservicesperpopulationisausefulmetricforhigh-levelcomparisons,itisrecommendedthatgeospatialaccessibilitymodelsbedeveloped.Bytakingintoaccountadditionalfactorssuchastraveltime,thesemodelspro-videamoreaccuratereflectionoftheactualaccessibilitytoandcoverageofessentialhealthservices.

9

Kabul

Kapisa

Logar

Maidan

Wardak

Panjsher

Parwan

Bamyan

Daykundi

Ghazni

Khost

Paktika

Paktya

Kunar

Laghman

Nangarhar

Nuristan

Badakhshan

Baghlan

Kunduz

Takhar

Badghis

Farah

Ghor

Hirat

HeRAMSAfghanistanStatusUpdateReportJanuary2023

Numberofhealthfacilitiesprovidingspecializedservicesper250,000population10

MDRTB

Managementofsevere

and/orcomplicated

communicablediseases

Isolationunitorroom

MDRTB

Managementofsevere

and/orcomplicated

communicablediseases

Isolationunitorroom

Capital

0.4

7

0.9

0.8

6.1

0.8

3.7

2.9

14.9

3.1

3.7

1.9

3.4

2

0.9

1.4

3.1

1.9

Northern

0.8

2.5

0.4

2.4

4.4

1.4

1.4

1

1.5

2.7

0.6

1.8

0.8

1.9

1.7

Balkh

Faryab

Jawzjan

Samangan

Sar-E-Pul

Central

Highland

5.5

4.7

5.1

14.2

2.4

1.5

South

Eastern

5.4

7.7

2.4

1

2.6

10.5

1.2

2.3

1.8

0.2

1

1

Eastern

2.3

2.7

2.6

0

5.9

3.9

2.7

22.4

1.8

0.6

2.9

3.4

Southern

10.9

1.4

26.8

3.9

5.3

2.7

4.2

40.1

9.5

12

2.4

1.6

20.1

0.5

10.1

Hilmand

Kandahar

Nimroz

Uruzgan

Zabul

North

Eastern

0

8

0

0.4

3

5.1

2.4

2.3

3

0.9

0.4

0.2

Western

5.2

0.7

5.8

5.6

2.6

13.8

5.1

5

0.9

1.4

0.4

4

Serviceavailabilityper

250,000population

05>=1

10See

annexII

foranoverviewofprovincialpopulationesti-

10

Kapisa

Logar

1

50%

2

100%

2

100%

1

50%

1

50%

2

100%

1

50%

1

50%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

2

100%

2

100%

1

50%

1

100%

1

100%

1

100%

2

100%

1

50%

1

50%

2

100%

2

100%

1

50%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

3

100%

3

100%

1

33%

1

100%

1

100%

1

100%

1

100%

1

50%

2

100%

2

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

2

100%

2

100%

1

50%

1

50%

2

67%

1

33%

3

100%

2

67%

1

50%

1

50%

2

67%

Panjsher

Parwan

2

100%

150%

1

100%

1

50%

150%

1

100%

150%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

50%

1

50%

2

100%

1

100%

1

100%

1

100%

1

50%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

1

33%

2

67%

2

67%

2

67%

1

100%

Daykundi

Daykundi

32

56%

13

68%

48

84%

52

91%

13

68%

19

100%

8

233%100%9

136%100%2

100%

1875%

2080%

23

196%502

1667%

16

64%

1

4%

312%

1

8%

2288%

975%

1

33%

416%

1

8%

2

67%

15

60%2

100%

758%2

1

100%

1

100%

1

100%

1

100%

1

100%

1

100%

100%1

33%2

3

4

80%3

60%150%

100%

240%

1

50%

480%1

40%

50%2

1

100%100%

2396%

22

92%

1

4%

7

29%

1

100%

1

100%

Typeofbarrier%ofhealthfacilitiesreportingabarrier

100%2

2288%

975%

1

33%

CommunicableDiseasesServices

OverviewOfmainbarriersbyservice

Mainbarriersimpedingavailabilityofessentialhealthservicesbyprovince

Capital

Syndromicsurveillance

Eventbasedsurveillance

Malariaatthecommunity

level

Malariaattheprimary