The need to sustain funding for Afghanistan health system to prevent excess morbidity and mortality.

IF 1.7 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Eastern Mediterranean Health Journal Pub Date : 2023-02-26 DOI:10.26719/emhj.23.017

Najibullah Safi, Palwasha Anwari, Lakhwinder Sidhu, Abdul Ghani Ibrahimi, Ahmad Rasekh, Saha Naseri, Wazhma Salemi, Nilmini Hemachandra, Paata Chikvaidze

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引用次数: 1

Abstract

Background: The Afghanistan Reconstruction Trust Fund, managed by the World Bank through a contracted-out instrument called Sehatmandi, financed health service delivery in Afghanistan, with substantial achievements in infant, child and maternal health. After the collapse of the Afghan Government on 15 August 2021, the health system has been on the brink of collapse.

Aims: We assessed the use of basic health services and estimated excess mortality resulting from the interruption to healthcare funding.

Methods: We conducted a cross-sectional study that compared health services utilization from June to September for 3 consecutive years, 2019, 2020 and 2021, using 11 output indicators reported by the health management and information system. We used the Lives Saved Tool, a linear mathematical model with input data from the Afghanistan Demographic Health Survey 2015, to calculate the additional maternal, neonatal and child mortality at 25%, 50%, 75% and 95% reduction in health coverage.

Results: During August and September 2021, after the announced ban on financing, health service utilization decreased to a range of 7-59%. Family planning, major surgeries and postnatal care showed the greatest decreases. Uptake of child immunization showed one-third decrease. Sehatmandi provides around 75% of primary and secondary health services: pausing funds to this programme will result in additional 2862 maternal deaths, 15 741 neonatal deaths, 30 519 child deaths, and 4057 stillbirths.

Conclusion: Sustaining the current level of health services delivery is crucial to avoid excess, preventable morbidity and mortality in Afghanistan.

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需要继续为阿富汗卫生系统提供资金，以防止过高的发病率和死亡率。

背景:阿富汗重建信托基金由世界银行通过一个名为Sehatmandi的外包工具管理，为阿富汗的保健服务提供资金，在婴儿、儿童和孕产妇保健方面取得了重大成就。阿富汗政府于2021年8月15日垮台后，卫生系统一直处于崩溃的边缘。目的:我们评估了基本卫生服务的使用情况，并估计了因医疗保健资金中断而导致的超额死亡率。方法:采用卫生管理与信息系统报告的11个输出指标，对2019年、2020年和2021年连续3年6 - 9月的卫生服务利用情况进行横断面研究。我们使用“拯救生命工具”(一个线性数学模型，输入数据来自2015年阿富汗人口健康调查)来计算健康覆盖率降低25%、50%、75%和95%时的额外孕产妇、新生儿和儿童死亡率。结果:2021年8月和9月，禁止融资后，卫生服务利用率下降到7-59%。计划生育、大手术和产后护理的降幅最大。儿童免疫接种率下降了三分之一。Sehatmandi提供约75%的初级和二级保健服务:暂停该方案的资金将导致2862名产妇死亡、15 741名新生儿死亡、30 519名儿童死亡和4057名死产。结论:维持目前的保健服务提供水平对于避免阿富汗出现过多的、可预防的发病率和死亡率至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Eastern Mediterranean Health Journal HEALTH CARE SCIENCES & SERVICESPUBLIC, ENV-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

CiteScore

3.30

自引率

4.80%

发文量

112

期刊介绍： The Eastern Mediterranean Health Journal, established in 1995, is the flagship health periodical of the World Health Organization Regional Office for the Eastern Mediterranean. The mission of the Journal is to contribute to improving health in the Eastern Mediterranean Region by publishing and publicising quality health research and information with emphasis on public health and the strategic health priorities of the Region. It aims to: further public health knowledge, policy, practice and education; support health policy-makers, researchers and practitioners; and enable health professionals to remain informed of developments in public health. The EMHJ: -publishes original peer-reviewed research and reviews in all areas of public health of relevance to the Eastern Mediterranean Region -encourages, in particular, research related to the regional health priorities, namely: health systems strengthening; emergency preparedness and response; communicable diseases; noncommunicable diseases and mental health; reproductive, maternal, child health and nutrition -provides up-to-date information on public health developments with special reference to the Region. The Journal addresses all members of the health profession, health educational institutes, as well as governmental and nongovernmental organizations in the area of public health within and outside the Region.