Capacity, Key Accomplishments and Situational Analysis for NCDs in South Asian Countries

Afghanistan

Capacity, Key Accomplishments, and Situational Analysis

The public health system was completely disrupted during the conflict years and is being rebuilt. Currently, the Ministry of Public Health does not directly provide health services. The private sector is the prominent source of outpatient services, especially in urban areas, and includes both not-for-profit nongovernmental organizations (NGOs) and for-profit providers and

contractors.

These services are either contracted through the Ministry of Public Health or external contractors. The for-profit sector provides mainly curative care. The Basic Health Package Services (BHPS) were developed and introduced in 2003. Mental health services, currently a component of the BHPS, are fairly well developed. They include awareness, education, and case detection at the primary health post for depression, psychosis, anxiety disorder, and substance abuse, with appropriate referrals and rehabilitation plans.

In addition, several capacity-building projects for mental health services have been initiated, including the Primary Mental Health Project, which focuses on training and increasing awareness of mental health issues; the Aga Kahn University Mental Health Project, which focuses on building mental health capacity and on training for health workers (community

surveys are being conducted to assess impact); the Psycho Social and Health Project, which aims

to provide psycho-social support to women traumatized by violence, through case supervision,

monitoring, and referrals; and Medica Mondiale (Afghanistan), which supports women and girls

through psycho-social support, legal assistance, advocacy, trauma training, and development of

psycho-therapeutic treatment standards.

Treatment of hypertension and respiratory conditions are included at the district hospital level. However, symptomatic care of IHD and diabetes is only provided at the provincial level. The public sector lacks institutions with technical expertise in hypertension, diabetes, cancer, mental health, injury, and tobacco control.