Afghanistan
Key Policy Options and Strategic Actions
Assess
* Move towards integrated surveillance which includes communicable diseases and then phase inbehavioral NCD surveillance that includes tobacco and mental health. The way forward for
broader surveillance will be to take stock of public and private institutions that may play key
roles, including NGOs that are services providers and that track morbidity and mortality. Basic
data are needed to develop sound policy and prevention efforts. Adult tobacco use is uncharacterized, although small studies suggest that use is high as is found among youth.
Plan
* Identify a central node to coordinate NCD efforts. Much mental health activity is under way.
Strategic assessment, policy development, and implementation can be led or coordinated by
this unit.
* Convene stakeholders and consider a strategic NCD plan. Stock taking among major stakeholders is needed. While competing priorities for many other issues are likely to displace NCDs, there are still opportunities to start in a few key areas.
Develop and Implement
* Strengthen tobacco control policies. Taxation of tobacco is much lower than in other South Asian countries. Harmonizing with other countries would increase impact.
* Strengthen service delivery for NCDs. Key issues are increasing skills for NCD diagnosis and
treatment among human resources, and increasing the level of infrastructure for basic NCD
management. Also, special attention is warranted for mental health. MoPH should consider
inclusion of NCDs in the Basic Package of Health Services and the Essential Package of Health
Services, keeping national priorities in mind.
* Develop financing strategies to assure access and protect the poor. A high proportion of care is
out of pocket, as throughout the region. Simple, inexpensive, and highly effective treatments
are likely being forgone by some people.
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