Afghanistan's Basic Package of Health Services: Its development and effects on rebuilding the health system

Figures & data

Figure 1. Components of Afghanistan's Basic Package of Health Services 2003.

Source: Ministry of Health (2003): A Basic Package of Health Services for Afghanistan, 2003/1382. Kabul: MOH, Islamic Republic of Afghanistan; 2003.

Table 1. Access: Active health facilities and health posts and rural and total population per BPHS facility, 2004–2011.

	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Active BPHS health facilities registered^a	1075	1178	1132	1200	1493	1687	1837	1829	1.70
Per cent change year-to-year		10	−4	6	24	13	9	0
Active BPHS health facilities reporting^a (percentage of registered facilities reporting)	392 (36)	828 (70)	986 (87)	1079 (90)	1326 (89)	1511 (90)	1671 (91)	1689 (92)	4.31
Per cent change year-to-year health facilities reporting		111	19	9	23	14	11	1
Active health posts reporting	631	4818	7116	9702	10,922	11,147	11,426	12,213	18.35
Per cent change year-to-year		664	48	36	13	2	3	7
Rural population per BPHS facility	15,175	14,247	15,245	14,789	12,223	11,124	10,505	10,849	0.71
Total population per BPHS facility	19,157	17,985	19,254	18,677	15,437	14,049	13,267	13,702	0.72
Total population	20,593,695	21,186,183	21,795,718	22,412,820	23,047,394	23,699,935	24,370,952	25,060,917	1.22

Source: MOPH, various HMIS reports, 2004–2011.

^a Health facilities include health sub-centres, basic health centres, comprehensive health centres and district hospitals.

Table 2. Utilisation: Patient visits and services at health posts and health facilities, 2004–2011.

	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Total patient visits to health posts and health facilities	2,046,038	9,310,085	16,446,547	21,355,120	29,670,418	36,972,745	40,365,444	44,773,537	21.88
Average number of patients receiving health services daily at clinics and outreach services	6537	29,745	52,545	68,227	94,794	118,124	128,963	143,046	21.88
Per cent change year-to-year		355	77	30	39	25	9	11
Average number of patient visits per health facility per month	435	937	1390	1649	1865	2039	2013	2209	5.08
Per cent change year-to-year		115	48	19	13	9	−1	10

Source: MOPH, various HMIS reports, 2004–2011.

Table 3. Maternal mortality, 2002 and 2010, and utilisation of maternal health services, 2004–2011.

	2002	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Maternal mortality ratio, national (maternal deaths per 100,000 live births)	1600							327
Total deliveries at health facilities		10,580	44,576	100,661	193,967	294,288	330,137	369,710	441,683	41.75
Per cent change year-to-year			321	126	93	52	12	12	20
Women of childbearing age receiving TT2		58,341	326,300	601,882	747,096	863,723	908,578	1,015,073	1,460,728	25.04
Per cent change year-to-year			459	85	24	16	5	12	44

Source: MOPH, various HMIS reports, 2004–11; Bartlett et al., 2005; Afghan Public Health Institute Ministry of Public Health et al., 2011.

Table 4. Infant and child mortality, 2002, 2006 and 2010, and utilisation of child health services, 2004–2011.

	2002	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Infant mortality rate, national (deaths per 1000 live births)	165			129				77
Under-five mortality rate, national (deaths per 1000 live births)	257			191				97
Children <1 year of age receiving Penta3 vaccine		77,366	415,251	631,944	726,855	898,861	870,123	927,711	1,041,671	13.46
Per cent change year-to-year			437	52	15	24	−3	7	12

Sources: MOPH, various HMIS reports, 2004–2011; 2002 and 2006 mortality figures: Ministry of Public Health, 2008; 2010 mortality figures: Afghan Public Health Institute Ministry of Public Health et al., 2011.

Table 5. Access: Service delivery for communicable disease tuberculosis, 2004–2011.

	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Health facilities with DOTS services	45	200	545	776	882	1114	1071	1111	24.78
Per cent change year-to-year		344	173	42	14	26	−3	4

Source: MOPH, various HMIS reports, 2004–2011.

Table 6. Health workforce: Females as a proportion of the health workforce, facilities with female health worker, and midwives per 10,000 population, 2004–11.

	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Active female CHWs	729	3995	5964	9185	10,147	10,576	10,300	10,980	15.06
Per cent change year-to-year		448	49	54	11	4	−3	7
Female CHWs as per cent of total CHWs	44	47	50	50	50	49	48	48	1.09
Per cent change year-to-year		7	5	0	0	−1	−2	0
Per cent of BPHS and EPHS facilities with at least one female health worker	54	57	77	79	77	79	74	74	1.37
Per cent change year-to-year		6	34	3	−2	2	−5	−1
Midwives per 10,000 population	0.08	0.27	0.52	0.64	0.70	0.80	0.79	0.82	10.25
Per cent change year-to-year		235	93	23	10	14	−2	3

Source: MOPH, various HMIS reports, 2004–2011.

Table 7. Supply of medicines: Stock-outs and expenditure for drugs and contraceptives for health facilities, 2004–2011.

	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Per cent of BPHS and EPHS facilities with at least one essential drug stock-out	80.3	70.4	78.9	76.3	70.0	66.8	66.8	61.0	0.76
Per cent change year-to-year		−12	12	−3	−8	−5	0	−9
Annual expenditure for drugs and contraceptives (US$) for 13 USAID-funded provinces	1,036,983	3,027,657	3,729,524	3,301,793	3,062,378	5,309,348	4,804,968	5,058,723	4.88
Per cent change year-to-year		192	23	−11	−7	73	−9	5

Source: MOPH, various HMIS reports, 2004–2011; Management Sciences for Health, procurement records.

Table 8. Governance: Number of health shura (committee) meetings, 2004–2011.

	2004	2005	2006	2007	2008	2009	2010	2011	Change factor 2004–2011 from 2004 baseline
Number of meetings with health shura (committee)	972	5101	7613	10,566	11,422	12,387	11,442	12,452	12.81
Per cent change year-to-year		425	49	39	8	8	−8	9

Source: MOPH, HMIS reports 2004–2011.

Ministry of Health. (2003). A Basic Package of Health Services for Afghanistan 2003/1382. Kabul: Transitional Islamic Government of Afghanistan. Retrieved October 4, 2012, from http://unpan1.un.org/intradoc/groups/public/documents/apcity/unpan018852.pdf.

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