This New Project Is Improving Health Care Quality in Afghanistan

As Afghanistan works to rebuild itself after many years of conflict, the country’s health care system remains an area of concern. Despite recent significant improvements, access to health care remains a challenge for many Afghans, particularly those living in remote or rural communities. In addition, the outdated infrastructure, lack of critical amenities and facilities, and inadequate opportunities for medical training that are standard in most parts of Afghanistan mean that it can be difficult for providers to deliver health care beyond the most basic services.

However, Afghanistan’s health care system is set to get a major boost over the next few years through the Sehatmandi Project, a large-scale program launched in the summer of 2018 that aims to improve access to and quality of health care services across the country. Here are four things you need to know about this important project.

It will cover the entire country.

Many of the development programs or initiatives that deal with health care in Afghanistan do so in very targeted areas, often concentrating either on Kabul or on rural areas in the north of the country. The Sehatmandi Project is exceptional in that its scope includes 31 of Afghanistan’s 34 provinces. This means that Afghans all around the country will be able to benefit from the cohesive and holistic improvements to Afghanistan’s health care system that the project aims to implement. In addition, some of the project’s key focus areas include offering underserved populations beneficial services such as nutrition management and family planning programs.

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It is supported by a variety of national and international partners.

The Sehatmandi Project is a major, multi-year initiative with a budget to match: the total cost for the program’s three years of operation is estimated at US$600 million.

This cost will be covered by grants from three major funding entities:

The Afghanistan Reconstruction Trust Fund (ARTF)—Established in 2002, this multidonor trust fund is supported by 34 international donors under the overall management of the World Bank. It is one of the most important entities supporting Afghanistan’s ongoing rebuilding and development process.

The International Development Association (IDA)—Another arm of the World Bank, the IDA provides loans and grants to some of the world’s poorest countries, with the aim of boosting economic growth and lifting these nations out of poverty.

The Global Financing Facility (GFF)—This multi-stakeholder partnership helps governments of low- and lower-middle income countries to prioritize and finance their citizens’ health and nutrition.

In addition to these three major funders, the Sehatmandi Project involves many other administrative and operational partners, including Afghanistan’s Ministry of Public Health and Health Works, a global NGO based in the Netherlands.

It aims to build on the successes of a previous program.

The Sehatmandi Project is a follow-up to the System Enhancement for Health Action in Transition (SEHAT) program, another initiative operated by Afghanistan’s Ministry of Public Health and supported by IDA and ARTF.

Running from January 2014 to June 2018, SEHAT aimed to expand the scope, quality, and coverage of health care services provided to Afghans, especially vulnerable and underserved populations. A key goal of SEHAT was to allow health facilities across Afghanistan to deliver a basic package of health service (BPHS) and an essential package of hospital service (EPHS). The successes of the SEHAT program have laid an important foundation for the Sehatmandi Project, which can now pick up where the earlier program left off and take its accomplishments to the next level.

Some of the most important achievements of the SEHAT program include the following:

Better health services in Nangarhar province—SEHAT oversaw new health initiatives in each of Nangarhar province’s 22 districts. For example, with the support of the SEHAT program, personnel at the Kama District Hospital were able to upgrade their skills and provide better care to patients, and the hospital itself received a second ambulance and a power generator.

The Kabul Urban Health Project—The Rahman Mina Hospital, a Kabul hospital that serves hundreds of thousands of the city’s residents, benefited from extensive renovations and new equipment provided under SEHAT. In addition, the hospital was able to increase its supply of critical medicines, and hospital staff received training on a new health management information system, which improved the facility’s operational efficiency.

It now includes a pay-for-performance component.

In early 2019, Aga Khan Health Services (AKHS) took over the management of health care facilities in two Afghan provinces under the umbrella of the Sehatmandi Project. In this new role, AKHS will be responsible for two provincial hospitals, five district hospitals, 24 comprehensive health centers, 158 basic and primary health centers, and more than 1,000 village health posts in the provinces of Bamyan and Badakhshan.

Interestingly, AKHS plans to operate its portion of the health system using a pay-for-performance model, which will see health service providers compensated for meeting pre-established benchmarks, including numbers of antenatal and postnatal care visits, numbers of immunized infants, and quantity and quality of major surgeries.

This Afghan Village Is Famous for Its Amazing Pottery

The small Afghan village of Istalif lies about an hour’s drive north of Kabul. It is perched in the foothills of the Hindu Kush, whose tree-covered slopes rise sharply from the river below.

Istalif is not only a site of incredible natural beauty, it’s also home to a distinctive tradition of pottery-making that stretches back hundreds of years. Read on for a rare glimpse of the unique village of Istalif and its traditional ceramics.

Istalif was once an emperor’s favorite picnic spot.

With its blossoming trees, ancient gardens, and winding river, the village of Istalif has never been short of admirers. Perhaps the most famous of these was the great Mughal emperor Babur, a descendent of Genghis Khan, who captured Kabul in 1504 and ruled the region for decades afterward.

A man who spent much of his life on long and difficult campaigns, Babur was captivated by the peace and tranquility of Istalif. He bought a garden, the Bagh-i-Kalan, on the slopes above the river. This garden became his favorite place to come to recover from fighting and campaigning with picnicking and drinking parties. Later in life, Babur wrote of Istalif, “when the trees blossom, no place in the world equals it.”

According to legend, the potter’s community in Istalif was founded over 300 years ago.

While the history of pottery in Istalif has never been formally documented, local oral tradition has it that the village’s pottery tradition began more than 300 years ago. The founder of Istalifi pottery is said to be Sayed Mir Kolal. This potter from Bukhara (in present-day Uzbekistan) traveled to Afghanistan with his four sons in order to escape political upheaval.

When they reached Istalif and saw its rich clay deposits, abundance of water, beautiful surroundings, and easy proximity to the markets of Kabul, they knew they had found their new home. Today, Istalifi potters still believe that they are each descended from one of Mir Kolal’s four sons.

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Image by egerstner | Flickr

Pottery in Istalif is a family affair.

Given the story of its founding, it’s hardly surprising that the pottery tradition in Istalif is very much a family affair. The secrets of this art form have been passed down from father to son through many generations. From a young age, a family’s sons become potter’s apprentices, training daily with their fathers and uncles.

Every son is automatically considered part of the pottery clan. Even those that never master the art of throwing pots are still involved in the business (acting as salesmen for the family, for example), and are still considered to be “potters.”

The women of the family also take part, applying the glaze and engraving the intricate patterns on the shaped pieces. Today, there are around 50 or 60 families of potters in Istalif. For each of them, pottery is much more than just a profession: it is their very identity.

Istalifi ceramics are known for their distinctive glaze.

The most unique feature of Istalifi ceramics is the special turquoise glaze that is applied to the finished pieces. Made from ishkar, a type of mountain plant only found in certain provinces in northern Afghanistan, this glaze was central to the development of Istalif’s distinctive ceramic tradition.

To produce the glaze, the root of the ishkar plant is burned and the ash is ground into powder. This is then mixed with water and combined with quartz and copper oxide (both of which are easily sourced from the area around Istalif). The resulting mixture, a striking, sea-green glaze, is then used to cover the ceramics after firing.

Istalif was almost destroyed in the late 1990s.

Istalif’s status as a renowned center for ceramics is all the more incredible given the village’s tumultuous past. Istalif was destroyed (for the third time in its history) as a result of the conflict in the late 1990s.

The village itself was burned to the ground, and the residents were forced to flee. Before they left, however, many families secretly buried their pottery tools in the hopes that they would one day return to their homes and businesses.

The village is rebuilding itself and its arts and crafts traditions.

Happily, the renaissance that these exiled Istalifis hoped and planned for has indeed come to pass. Over the past 15 years, potters and their families have been slowly returning to Istalif and taking up their tools once more.

These resilient people have been helped in their efforts to rebuild their artisanal community by organizations like Turquoise Mountain. One of the most important NGOs focused on traditional arts and crafts in Afghanistan, Turquoise Mountain has worked closely with Istalifi potters to revive the village’s ceramic traditions, and to find new markets for its work.

Today, ceramics instruction is one of the main subjects at the Turquoise Mountain Institute. Faculty include Istalifi potters like Abdul Matin Malekzadah and Ustad Abdul Matin.

Spotlight on 3 Amazing Organizations That Are Led By Young People

Did you know that Afghanistan is home to one of the world’s youngest and fastest-growing populations? According to the United Nations Population Fund, nearly two-thirds of all Afghans—about 64%, or around 22 million people—are under 25 years of age. And although this young cohort has a difficult legacy of conflict and instability to contend with, they are already showing an incredible determination to build a better life for themselves, their families, and their country. Read on for a look at three inspiring youth-led organizations in Afghanistan that are taking the future into their own hands.

Afghans for Progressive Thinking

As Afghanistan’s largest youth-led professional organization, Afghans for Progressive Thinking (APT) works to promote and foster a culture of openness, tolerance, and respect among Afghan young people, particularly college and university students.

APT was founded in 2010 by a political science university graduate who was certain that many other Afghan youth shared his vision of a peaceful and progressive Afghan society. He believed that they simply needed a structure within which they could work toward that vision. APT is the result. It’s an organization based on two social theories of change, critical thinking theory and contact theory, which it uses as touchstones in its work of disrupting existing systems, opening channels of communication, and building understanding of and respect for diversity. Since it was founded, APT has worked with more than 20,000 university students from more than 35 Afghan universities.

Today, APT’s work encompasses a diverse array of activities, programs, and initiatives. These include:

UN youth representative—APT was an instrumental force in helping to select Afghanistan’s first ever youth representative to the United Nations in 2018. With support from the Netherlands Embassy in Kabul, APT worked with a number of Afghan government ministries and other organizations to develop a candidate selection program for youth delegates and to attract applicants. After a multi-stage process, 28-year-old Ramiz Bakhtiar was chosen as Afghanistan’s youth representative to the UN following a live debate at the Bayat Media Center in Kabul.

Leadership development—APT organizes a number of annual leadership development courses designed to help young students prepare to exercise leadership in their own communities and become effective influencers in Afghan society. Held in both English and Dari, these courses are taught by professional experts from Afghanistan and abroad.

Young Peace Builders Award—This award is given annually to three or four Afghan youth who have made significant contributions to promoting tolerance and peacebuilding in Afghanistan. The inspiration for this award comes from the United Nations Security Council Resolution 2250 on Youth, Peace, and Security, which recognizes the positive role that youth can play in helping bring peace and security to their home countries.

Youth 4 Change and Development

Youth 4 Change and Development (YCDO) is a non-profit NGO, led entirely by Afghan youth, that aims to create a culture of mutual cooperation and understanding among all the different actors working in the field of youth welfare in Afghanistan, including youth voluntary agencies, youth groups and clubs, and individuals. Founded in response to the disenfranchisement and neglect experienced by many Afghan youth, YCDO strongly believes that youth empowerment and capacity building is an essential part of ensuring Afghanistan’s ongoing development, as well as its long-term stability and prosperity.

As part of its mission to inspire Afghan youth to create positive change within their communities, YCDO organizes a variety of programs and events, including:

The Social Good Summit—In late 2017, YCDO partnered with the United Nations Development Program to organize a summit on the theme of Afghanistan’s future and creative strategies for attaining the UN’s Sustainable Development Goals. The summit brought together hundreds of participants from civil society organizations, government, the private sector, and youth groups and university organizations.

The Afghanistan National Youth Assembly—Initiated by YCDO in 2017 and led by a team of committed young Afghans, the Afghanistan National Youth Assembly is the country’s first ever platform for youths to make their voices heard, share their ideas, and contribute to a strong foundation for positive change and development in Afghanistan.

Afghanistan’s New Generation Organization

From a movement of young activists in a single province, Afghanistan’s New Generation Organization (ANGO) has grown to become a network of passionate youth change agents all across the country. Based in Kabul, this independent NGO works at the grassroots level to inspire and support Afghan youth as they take an active role in leading Afghanistan towards a peaceful and progressive future.

To accomplish its mission of mobilizing and empowering youth, ANGO creates programs that are specially tailored to the unique needs of young people. In order to achieve a long-term, lasting impact, ANGO allows these programs to develop as a process, with a particular focus on sustainability beyond individual project cycles. At present, the organization’s activities and offerings are geared towards four core program areas: civic engagement and advocacy, citizen journalism, social inclusion, and capacity building.