Health Intervention IRC 2021-2022

This contribution concerns a health intervention to be implemented by the International Rescue Committee (IRC) in Afghanistan during 2021-2022.  The contribution is in line with the Swedish development strategy for Afghanistan 2021–2024, Sida's preconditions for aid in Afghanistan (2021-002014), and the perspectives that guide the Swedish development cooperation.  This intervention supports the health goal of the Swedish development strategy for Afghanistan which focuses on access to sexual and reproductive health and rights. In order to address SRHR it is imperative to enhance access to the broader health system in Afghanistan, something this intervention seeks to address. Sweden, through its support to the Afghanistan Reconstruction Trust Fund (ARTF), has been a longstanding contributor to Sehatmandi. This intervention also focuses specifically on addressing the SRHR needs of women, girls and the most vulnerable with emphasis on integration of protection programming.  Afghanistan’s public health statistics places the country among the worst in the world. While positive strides have been made during the last 20 years, the health system is now, following the Taliban takeover on 15 August 2021, on the brink of collapse. At such a time, it is important to help to maintain a minimum level of health care in the country and provide additional support to the Sehatmandi providers and directly implement programs in the areas that are not covered by Sehatmandi. The support to IRC is meant to complement and strengthen Afghanistan's national health program, Sehatmandi. Sehatmandi covers two main health programs in each province, the Basic Package of Health Services (BPHS) and the Essential Package of Hospital Services (EPHS). In this program, more than 30,000 health workers were employed in 3,678 active health facilities, giving opportunity for 90% of the population to access health services within two hours by foot. The packages were fully funded by World Bank, the European Commission and USAID through the ARTF, which was mainly managed by the World Bank. Sweden's bilateral annual development portfolio included substantial support to the ARTF. Most donor governments, Sweden included, decided to halt funding to the government after the Taliban takeover. The World Bank has since also pulled out of Afghanistan and there have been and continues to be ongoing talks on how to cover the gaps in service provision.  IRC will be working in the so called white areas that are not covered by the Sehatmandi program but also provide support to Sehatmandi partners in the areas where IRC already is working. The white areas are in the provinces of Helmand and Logar where IRC will run 5 static health facilities and 5 Mobile Health Teams. IRC, in all its directly implemented health services, will provide the same health package as Sehatmandi partners. The support to Sehatmandi partners will be in Helmand, Logar, Nangahar and Laghman. The support to Sehatmandi partners will focus on improving WASH infrastructure and build capacity in the areas of protection, SGBV and disease surveillance. An extensive network of Community Health Workers, previously trained by IRC, will also be activated and be a further link to the catchment populations where IRC will implement this intervention. This one year gap program, starting 1 December 2021, will allow short term support at a critical time, providing health care where there are no providers and supporting the existing partners to cope with the current situation. It is thus here suggested that support to IRC is a relevant and effective way for Sida to support the health care needs of vulnerable people in Afghanistan.