The continued war and conflict in Afghanistan have led to health workers’ severe shortage mainly caused by out-migration, poor and unequal distribution in rural compared with urban settings, and lack of capacities for formal development of professional cadres. There are only 7.26 doctors, nurses, and midwives per 10,000 population (WHR 2006). Based on current training plans, this figure is expected to increase to only 9.12 doctors, nurses, and midwives per 10,000 population over the next 5 years (Afghanistan National Health Workforce Plan 2012-16 (Draft), 2011). The ongoing training enrollments predict a continued gender imbalance among certain categories of health workers.
A number of strategic actions have been taken to address these problems. These include: the Ministry of Public Health (MoPH) and the Ministry of Higher Education (MoHE) established a joint committee to address HRH training issues, a Reform Implementation Management Unit (RIMU) in MoPH was created and refined the health care sector's mission, staff requirements, job analysis, organization chart, and new pay and grading, and a National Salary Policy was created to reduce pay imbalances between civil servants and NGO-contracted staff. Despite these developments, differing priorities among ministries and partner agencies has led to a lack of participation and funding for coordination and implementation of HRH efforts. There is also deficient collaboration with the private sector, which maintains its own mechanisms for data collection.
Country Coordination and Facilitation (CCF) in Afghanistan:
Afghanistan has completed CCF phase 1, consolidating the phase 2 and implementing the phase 3.
With the catalytic support by the Alliance from the GIZ funds, the CCF process was launched in Afghanistan in 2009 with a stakeholders orientation on multistakeholder coordination . An HRH stakeholders analysis was conducted and HRH Consultative Forum was created in 2010. Members include representatives from the following entities:
- Ministry of Public Health;
- Ministry of Higher Education;
- Ministry of Finance;
- Support to Health Service Provision;
- Techserve (MSH);
- Private Hospitals Association;
- Public Health Association;
- Integrity Watch Afghanistan;
- National Nursing Association;
- National Midwifery Association;
- CSC, USAID, World Bank, EU, and WHO.
Due to the combined efforts of the Alliance in initiating the CCF process and the political commitment and national ownership of the federal government and other stakeholders, the process has culminated in the development of a new National Health Workforce Plan for 2012-16, which is currently going through a revision process.
HEALTH WORKFORCE DATA
- The latest data from multiple WHO sources
Analysis of Stakeholders in Afghan Human Resources for Health (HRH) and Planning and Development for an Effective National HRH Coordination Forum
HUMAN RESOURCES FOR HEALTH PLAN
HEALTH SECTOR STRATEGIES / PLANS
- Strategic Plan for the Ministry of Public Health (2011-2015), Government of the Islamic Republic of Afghanistan
COUNTRY CASE STUDIES AND OTHER DOCUMENTS
Afghanistan: Progress amid challenges (2011)
AFGHANISTAN Country Coordination and Facilitation (CCF) for Human Resources for Health (HRH): The CCF works well even in an unstable situation
Establishing Human Resources for Health During Postconflict Reconstruction
The Role of Leadership in HRH Development in Challenging Public Health Settings