Islamic Republic of Afghanistan - Enhanced Integrated Framework ...

to advanced technology that can be of benefitin many areas of the economy. There will alsobe major indirect benefits from mining, includingthe construction of roads, bridges, housings,health clinics, mosques, playgrounds,schools and parks (for detail information referto Appendixes 3-National Action Plan and 4-Monitoring Matrix).HEALTH AND NUTRITIONThe ANDS strategic objective for this sector isto improve the health and nutrition of the peopleof Afghanistan through quality health careservice provision and the promotion of healthylife styles. Afghanistan ranks towards the bottomon global measures of health and nutrition.Improving health and nutrition is vital to improvingthe livelihood and well being of theAfghan people and to achieving the goals ofthe MDGS and the Compact which include:• By end-2010 the Basic Package of HealthServices will be extended to cover at least90 percent of the population;• By end-2010 maternal mortality will be reduced;• By end-2010 full immunization coveragefor infants under-5 for vaccine-preventablediseases will be achieved and their mortalityrates reduced by 20 percent;• Between 2003 and 2015 reduce the underfivemortality rate by 50 percent, and furtherreduce it to one third of the 2003 levelby 2020;• Between 2002 and 2015 reduce the maternalmortality ratio by 50 percent, and furtherreduce it to 25 percent of the 2002 levelby 2020;• To have halted and begun the reverse thespread of HIV/AIDS by 2020;• To have halted by 2020 and begun to reversethe incidence of malaria and othermajor diseases.For more details refer to the Appendices I andII (National Action Plan and Monitoring Matrices).Current SituationAfghanistan’s health indicators are near thebottom of international indices, and are farworse, in terms of their health, than any othercountry in the region. Life expectancy is low,infant, under-five and maternal mortality isvery high, and there is an extremely highprevalence of chronic malnutrition and widespreadoccurrence of micronutrient deficiencydiseases. For more information refer to volumeII.Achievements: Substantial improvements inthe health system and the health status of thepeople of Afghanistan have been achieved inrecent years.• Expansion of primary health care services.The percentage of the population living indistricts where the Basic Package of HealthServices is being implemented has increasedfrom 9 percent in 2003 to 82 percentin 2006. The percentage of people inAfghanistan who live within two hourswalking distance from a primary healthcare facility was approximately 66 percentin 2006.• Increased access to female health careworkers. The percentage of primary healthcare facilities with at least one female doctor,nurse or midwife has increased from 26percent in 2004 to 81 percent in 2007.• Increased use of reproductive health servicesin rural areas. Between 2003 and2006, use of a modern family planningmethod among married women in ruralAfghanistan increased from 5 percent to 16percent, receipt of skilled antenatal care bypregnant women increased from 5 percentto 32 percent and use of skilled birth attendantsfor assistance with delivery increasedfrom 6 percent to 19 percent.• Increased coverage of child immunizationin rural areas. Between 2003 and 2006, coverageof BCG vaccine among children 12-23months of age to protect against tuberculosisincreased from 57 percent to 70 percentand receipt of three doses of oral poliovaaccine increased from 30 percent to 70percent.• The Afghan Compact High Level Benchmarkfor reduction of infant mortality hasbeen reached ahead of schedule. From a108Afghanistan National Development Strategy (ANDS)