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Professional profile
Dr Nadera
Hayat Burhani
By Carmel Dolan, ENN
Dr Burhani, Afghanistan, 2012
Dr Burhani speaking at International
Day of the Midwife (2012)
ENN interview with Dr. Nadera Hayat Burhani, Deputy Minister for
Health Care Services Provision, Islamic Republic of Afghanistan
In February 2012, I interviewed Dr Nadera
Hayat Burhani, Deputy Minister for Health
Care Services Provision, Ministry of Public
Health (MoPH), Islamic Republic of
Afghanistan for Field Exchange. Dr Burhani
was a guest speaker at the CMAM Conference
held in Addis Ababa, Ethiopia in November
2011 1 . It was at this event that I met Dr Burhani
and agreed to a Field Exchange profile on nutrition
in Afghanistan and Dr Burhani’s
experiences of working in such a complex environment.
Dr. Burhani is a medical physician (obstetrics
and gynaecology speciality) and holds a
Masters in International Public Health. As
Deputy Minister for Health Care Services
Provision, she is responsible for overseeing all
aspects of nutrition from prevention to treatment
of malnutrition in emergency and
development situations. Previous to her current
appointment in September 2008, she was
Deputy Minister for Reproductive Health and
Maternal and Child Health for three and a half
years, following a clinical career as a gynaecologist/obstetrician
and physician in Balkh
Province, Afghanistan.
Q: How would you describe the current
nutrition environment (policy, resources,
coordination, visibility and programmes) in
Afghanistan?
The current policy environment is, Dr Burhani
explained, responsive to the current needs and
priorities of the country. The nutrition policy
and strategy has been developed as part of
health and nutrition sector strategy, which falls
under the Afghanistan National Development
Strategy (ANDS). Based on this policy, different
programmatic guidelines have been developed
to facilitate implementation of the policy. For
example, guidelines on the Management of
Acute Malnutrition, Infant and Young Child
Feeding (IYCF) and Micronutrients have been
developed recently 2 .
She described how two national legislations
have been developed and endorsed by the
Cabinet, one in support of breastfeeding and for
the control of marketing of breast milk substitutes
and the other, for Universal Salt Iodisation
(USI). According to these two national legislations,
two national committees comprised of
representatives of different sectors have been
established to oversee the implementation of
related programmes through a multi-sectoral
approach. We have to, she emphasizes, work on
the food safety and quality control policies and
guidelines, as well as the dietary guidelines, for
Afghans in the near future.
In terms of financial resources, we are in a
good position. The main donors of the MoPH
are USAID, the World Bank, and the European
Union (EU), who are financing the primary
health care services and nutrition is a key
component. Also, the Canadian International
Development Agency (CIDA) has committed to
three years funding to support implementation
of nutrition activities through the primary
health care system. UN partners are supporting
the MoPH to manage emergency response.
In terms of technical resources, we have a
department at the MoPH with technical staff to
support the implementation of nutrition
programmes according to the national priorities
and policies. This department plays an important
role in the stewardship role of the MoPH to
develop guidelines, policies, strategies, provide
technical assistance for implementing partners,
coordinate efforts with different stakeholders
and sectors and monitor the current
programmes. The MoPH is planning a long
term strategy to develop more technical capacity
in nutrition in the near future. Links have
been established with the University of
Massachusetts (US) and the London School of
Hygiene and Tropical Medicine (UK) to provide
opportunities for a team of Afghan professionals
to obtain a Master’s degree in nutrition.
Discussion with the Kabul Medical University,
Cheragh Medical University and the American
University of Afghanistan is on-going to establish
a pre-service education programmes on
nutrition (bachelor degree).
The key programmes in nutrition are USI,
IYCF and the prevention of micronutrients deficiencies.
These programmes are at different
stages of development to reach national coverage.
Our USI programme is a success story. It
started in 2003 and we now have an average of
61% coverage of iodised salt utilisation at the
national level with above 90% coverage in the
main cities. For IYCF we have had pilot projects
and based on lessons learnt, we are going to
scale up the programme to reach each breastfeeding
mother and her family in the country.
Our micronutrients supplementation
programme is mainly done through health
system structures and here we need to work
more to reduce iron, zinc, folic acid, vitamin C,
and vitamin A deficiency.
Coordination is a challenge, especially as
there are several actors. Dr. Burhani observed
that nutrition is a multi-sectoral activity and
requires involvement of several actors from the
government, UN, donor agencies and implementing
partners. To coordinate efforts at
different levels require serious steps. She
described how they are going to address this
challenge through different approaches.
‘Nutrition Partners’ is a committee comprised
of the main donors, UN agencies and some
technical agencies, where partners discuss
programmatic issues in terms of nutrition, especially
developmental interventions. The
Nutrition Cluster is another forum gathering
UN agencies, NGOs and government partners
to deal with emergency situations. Another
two good examples she had already mentioned:
the national committee for promotion of breast-
1
See footage of Dr Burhani’s presentations at www.cmam
conference2011.org
2
Available at www.moph.gov.af
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