Health

NAC works to give all Afghans equal rights, and the opportunity to decide on their own lives and their own sexual and reproductive health. Women’s access to education, health care and work are fundamental to achieving the goal of good health and quality of life for all.

Annually, NAC’s Health Program educates and trains more than one thousand healthcare workers from provinces throughout Afghanistan, covering one-third of the country’s population. In 2020, despite the challenges of the pandemic, we were able to maintain most of our health initiatives with a continued focus on maternal and infant health, physical rehabilitation, gender equity, COVID-19 awareness campaigns, and distribution of healthcare equipment and supplies to rural and hard-to-reach communities.

NAC educates midwives, nurses, medical lab technicians, pharmacists and physiotherapists for hospitals and the private sector in 15 provinces. Additionally, NAC trains community health nurses and midwives to work in rural clinics and health centers in some of the most hard-to-reach and conflict prone communities in the country. Our main health initiatives are conducted in three regional institutes of health sciences (IHSs) – which fall under the Ministry of Public Health (MoPH) – two of which we helped establish and develop. These partnerships were created to ensure continuity and sustainability as the staffing and programs in the three institutes will gradually be incorporated into government plans and budgets.

More than 250 young people are currently studying health sciences at the three state colleges supported by NAC. We are also working to strengthen the technical expertise of the colleges responsible for education in health sciences, while at the same time working to improve the administrative and professional competence within the Afghan Ministry of Public Health, both at national and sub-national levels.

Institution building

NAC works with three colleges in health education in: Gardez, Jalalabad and Kapisa. Collaboration with the College in Jalalabad, Nangarhar has been ongoing since 2002, while the Gardez College in Paktia was established in collaboration between NAC and the Ministry of Public Health in 2018. In 2019, a new campus was established in Khost province as a satellite under the Gardez College. The goal of a decentralized college with campuses in different provinces is to achieve greater regional ownership of the colleges outside the province in which the main college is based. The last of the three colleges was established in Mahmud-e-Raqi, Kapisa in October 2019 and is responsible for the education of health professionals from Bamiyan, Kapisa, Panjshir and Parwan.

Midwives, community health nurses and hospital nurses

NAC has trained more than 15 percent of all midwives and community health nurses in Afghanistan. In our efforts to ensure better access to health services in rural Afghanistan, we focus on educating health professionals from rural and hard-to-reach, and often highly conservative communities, suffering from acute health care shortages.

In 2020, we educated and trained key healthcare professionals from Bamiyan, Ghazni, Kapisa, Khost, Kunar, Laghman, Nangarhar, Nuristan, Panjshir, Paktia, Paktika, and Parwan for both public and private healthcare systems. In addition, we educated physiotherapists from rural and underserved communities of Kabul, Logar and Wardak, even though these provinces do not belong to the areas served by the three IHSs. Our programs educate and train more certified healthcare professionals than any other non-governmental organization in Afghanistan.

The many hundreds of midwives and health nurses we have trained over the past twenty years, help to reduce maternal and child mortality in Afghanistan. In addition to improve public health, education helps to create jobs for women and to strengthen the role of women, both in their families and in their home communities.

NAC’s midwifery and community health nursing schools are consistently evaluated as being among the best in the country. Nevertheless, we are continuously working to improve the quality of the three colleges we support, through: building the confidence and competence of teachers, an increased focus on occupationally relevant practices during the study period, and providing access to new knowledge and new equipment.

In all the schools we support, we also work to develop students’ and faculty members’ ICT and language skills, beyond what is required in the curriculum. We offer important elective courses, such as physical education, literature, art and culture. Entrepreneurship is also a compulsory subject in NAC supported health education programs, as many of those who graduate will have to create their own jobs, because there are only limited number of existing healthcare jobs available in the system, and most of these are not in the rural areas where our students come from.

In collaboration with the Nansen Center for Peace and Dialogue in Lillehammer, we also offer training in dialogue and peaceful conflict transformation. This is to help our health care professionals, who often have to negotiate with conflicting parties about access to patients, or for access to female patients who are hindered by their families from visiting health institutions due to cultural barriers.

Physiotherapists

In 2019, a cohort of sixty physiotherapists graduated from NAC supported physiotherapy schools in Kapisa and Kabul. Physiotherapy studies have now been moved to the new colleges in Gardez, Khost and Mahmud-e-Raqi (Kapisa) and over sixty new students were admitted in the fall of 2019.

The physiotherapists will mainly work in providing rehabilitation services for persons with disability. Such services are relatively new in Afghanistan and are offered both at state and private hospitals and clinics, but increasingly also at private physiotherapy institutes owned and run by physiotherapists themselves. This is why entrepreneurship is an important additional subject within the physiotherapy education NAC supports.

Together with our partners, we have already trained over 200 physiotherapists, and have just admitted 140 new students to a total of five colleges. Thousands of persons with disability across Afghanistan will benefit from this important work in the years ahead.

Sammen med våre partnere har vi allerede utdannet over 200 fysioterapeuter, og har akkurat tatt opp 140 nye studenter på til sammen fem høyskoler. Titusener av funksjonshemmede over hele Afghanistan vil i årene fremover nyte godt av dette viktige arbeidet.

Pharmacists and laboratory technicians

In 2018, NAC started training pharmacy technicians, pharmacists and laboratory technicians at Gardez College. Today, more than sixty young women and men from Ghazni, Khost, Paktia and Paktika study pharmacy and laboratory technology subjects at the college.

Although there are more men than women in these studies, the young female students are among the very first women from these provinces to study pharmacy and laboratory technology – they are therefore brave pioneers who break gender barriers and open up opportunities for new generations of girls and women in this part of Afghanistan.

Research

Afghanistan is one of the countries with the highest infant and maternal mortality rates in the world. In addition to the work of educating more midwives, it is therefore important to research how we can improve the quality of midwifery services in rural Afghanistan.

In 2017 and 2018, we conducted a qualitative study in two of the most conflict-prone provinces in eastern Afghanistan – Kunar and Laghman. The study included in-depth interviews of 39 women, and shed light on how shame and negative attitudes towards women, families and health professionals, contributed to many women not being able to access professional maternity care.

Research-based development of the Afghan health service is crucial to reducing infant and maternal mortality in Afghanistan, which is why we are planning several additional research projects in the years to come.