HEALTH RESOURCES INFORMATIONFOR REHABILITATION AND RECONSTRUCTIONOF THE HEALTH SYSTEM IN AFGHANISTAN Prepared by :Health Information System (HIS) WHO Afghanistan Program, Peshawar May, 1992 PART-I - (Provinces: Badakhshan Kapisa) HEALTH RESOURCES INFORMATIONFOR REHABILITATION ANDRECONSTRUCTION OF THE HEALTH SYSTEM INAFGHANISTAN Prepared by :Health Information System (HIS) WHO Afghanistan Program, Peshawar May, 1992 PART-I (Provinces: Badakhshan Kapisa) PREFACE We are pleased to present an updated version of WHO database. Without the assistance and feedback of the NGOs, UN- Agencies, MOPH and donor agencies, it would not have been possible to produce such a comprehensive document. We hope thatthisinformation will be of use for future planning to rehabilitate and reconstruct the health system of Afghanistan. Afghanistan is changing rapidly in a positive way and in order to keep the database updated we would like to invite you to keep us informed about these changes specially within your own organization. Thanks for your cooperation. Jan Theunissen, MD, MPH WHO Field Coordinator INTRODUCTION Information is a tool for planning, monitoring and evaluation of any program activity in any sector. The same is true for Health system. Health system needs data on resources, demography, epidemiological data on disease and health needs. In Afghanistan, during the past thirteen.- years the country was under a fragmented controlof the deposed government and differentfactions of mujahideen. Information was likewise fragmented and unverified. From its inception WHO /HIS has been gathering data on health resources- both health manpowerand health facilities existing in Afghanistan. These data have been regularly updated and verified as far as possible. Demographic data provided by Thomas Eighmy of ,. USAID has been entered into the data base as soon as it was available. This population,data again has been projected to the present year using the same procedure of projection originally done. Thus, the information in WHO /HIS database is one of the most reliable and complete information related to health in Afghanistan. Now, that the information is available and situation has changed in favor of reconstruction and rehabilitation of Afghanistan including the Health system, the time is nature to utilize the data and analyze it for a careful and judicious planning of health system in Afghanistan. In the present document the data entered in the database has been presented in the following manner: I. Health Facilities: 1. List of Health Facilities in Afghanistan: this document provides a quasi- detailed information on the health facilities about their level, locationinthe district up -tothe villagelevel,special services available, along with the identification codes for the facilities, their supporting programmes and monitoring information. Cross -tabulationof healthfacilitiesdistribution by districtsin Afghanistan. This provides information on the number of different levels of health facilities existing in the districts of each province; the names of the NGOs supporting the different levels of the health facilities in the province. This is complemented by information on population, area, and altitude of the province and its districts. 3 An analysis of the requirement (total and additional) of health 'facilities in the whole province and in each district. The calculation has been based on the estimated high and low population coverage by each level of health facility and the projected total population of the province /district. 4. Graphics presentation of the existing health facilities and additional required facilities by their location. 5. Thematic maps of health facilities according to their proper location with latitude and longitude. II. Health Manpower: I. List of Health. Workers containing information on: their Identification codes, supporting programmes, training level, name and father's name of the health workers, code of the health facility they are working in, and location in the district up -to the village level. 2. Cross -tabulation of different levels of the health workers by their location and also their supporting programmes indicating the total number of different levels of health workers in each district. 3. Analysis of the available health manpower: viz, the estimation of population served by each BHW, MD, ML, Nurse or vaccinator in each province and the number of BHWs, MDs, MLs and Nurses per 50,000 population by districts. 4. Graphic presentation of the existing health manpower and in relation to population. Health Information System (HIS) WHO Afghanistan Programme, Peshawar TABLE OF CONTENT Abbreviations used throughout the document: I. Classification of Health Facilities. II. NGOs /Agencies supporting health activities in Afghanistan. III. Health Workers training levels IV. Code list of special services offered at the health centers. AFGHANISTAN l . Crosstab: Health Facilities distribution in Afghanistan: Facility level by province. 2. Crosstab: Health Facilities distribution in Afghanistan: Facility level by their supporting programs: 3. Crosstab: Health Facilities requirement in Afghanistan by province according to facility coverage. 4. Graph: Total No. ofExisted Health Facilities by province 5. Graph: Population per C -2, C -1 and H -3 level Facilities. 6. Graph: Major programs share of Health Facility 7. Graph: Total C -2 Fac. requirement by province S. Graph: C -2 level Fac. requirement by province (Existed and Additional required) 9. Graph: Total C -I Fac. requirement by province 10. Graph: C -1 level Fac. requirement by province (Existed and Additional required) I t. Graph: Total H -3 Fac. requirement by province 12. Graph: 11-3 level Fac. requirement by province (Existed and Additional required) 13. Crosstab: Health Care Workers distribution in Afghanistan: Health workers level by province 14. Crosstab: Health Care Workers distribution in Afghanistan: Health workers level by their supporting programs 15. Crosstab: Health Manpower indices in Afghanistan (Population per BHW, MD, ML, Nurse, and Vaccinator) 16. Graph: Population per Basic Health Worker by province 17. Graph: Population per Medical Doctor (MD) by province IS. Graph: Population per Mid -Level Health Worker (ML) by province 19. Graph: Population per Nurse by province 20. Graph: Population per Vaccinator by province 21. Graph: Major programs share of health workers BADAKHSHAN 11 t. List of healthfacilities: Single line facilities report 2. Crosstab: Health Facility distribution by districts /supporting programs 3. Crosstab: Itealth Facilities requirement by district according to facility coverage. (Planning review of C -2 and C -I level health facilities) 4. Graph: C -2 Facility requirement by district: Coverage 30,000 Population /Facility 5. Graph: C -1 Facility requirement by district: Coverage 50,000 Population /Facility 6. Map: Map of health facility according to facility location with latitude and longitude. 7. List of IlealthCare Workers : Single line health workers report 8. Crosstab: I lealth Care Workers distribution in Afghanistan (I ICWs level by districts /supporting programs) 9. Crosstab: Ilcalth Manpower Indices in Afghanistan (BHWs, MDs, MLs and Nurses per 50,000 Population) 10. Graph: Health Workers distribution by district (BHWs, MDs, MLs and Nurses per 50,000 Population) CONTENTS FOR THE REST OF THE PROVINCES ARE THE SAME AS BADAKHSHAN BADGHIS 19 BAGIILAN 13 BALKH 16 BANYAN 28 FARAH 21 FARYAB 18 GHAZNI 06 GHOR 27 HELMAND 23 HERAT 20 JAWZJAN 17 KABUL 01 KANDAHAR 24 KAPISA 02 KUNAR 10 KUNDUZ 14 LAGHMAN 09 LOGAR 05 NANGARHAR 08 NIMROZ 22 ORUZGAN 26 PARTIRA 29 PARTYA 07 PARWAN 03 SAMANGAN 15 TAKHAR 12 WARDAK 04 ZABUL 25 r Abbreviations Classification of Health Facilities DESCRIPTION OF Regional Provincial Primary Comprehensive Basic Health Basic Health Health Center Center Post THE Hospital Hospital Care Hosp. FACILITY I1 -1 H -2 H -3 C -1 C -2 C -3 HEALTH PERSONNEL: - -- - M.D Doctors Many 3 + 1- 3 1 -- Surgeons 1 + 1 + Maybe -- - -- - -- - Mid-level }I \Vs Yes Yes Yes Yes 1 + - -- Basic II. Workers -- -- Maybe Maybe Maybe I + - TOTAL HEALTH STAFF 16 -20 12 -16 8 -12 4 -8 2 -'4 1 -3 IIEAL'l'H FACILITIES: --- - Up:lation theater Specialized Major Minor " --- - -- - Laboratory Supervisory Referral Field Field - -- --- - X -Ray Yes Yes Yes - -- - -- - -- - Inpatient Bed. 50 - 100 20 - SO IO - 20 3 - 5 - -- - -- - Specialized ßogrants Supervisory Yes Planned Maybe - -- - -- (r8. Malaria. etc.) - Medical Records Yes Yes Pt. Card Pt. Card Pt. Card Varies - Transport (Refers) Yes Maybe Maybe - -- -- 1 30 - 50,000 5 - 30,000 500 - 5,000 Coverage: 3 - 6 1- 2 - 3 Provinces Provinces Districts Population Population Population Initial .Refresher DAI - -- --- Services Provided: Training Training Training Classification of Vaccine Storage Facilities (V S F) Regional Vaccine Storage Facility Provincial Vaccine Storage Facility On -site Vaccine Storage Facility Description of the VSF - 3 VSF -1 VSF - 2 ("S F) A B V B C A B C Criteria for the VSF - SO - 200 50 - 200 50 - 200 30 - 50 30 - 50 3050 - Capacity in doses > 200 > 200 > 200 Thousand Thousand Thousand lhuaund Thousand Thousand Thousand Thousand Thousand Yea Yea - Safety StmtJanls Yes Yes Yea Yes Yes Yes Yes Double Double Single - Energy Supply: Double Double Single Double Double Single Double = Gus f liteetricily Single = lias or Electricity Yea Yes Yea Yeu Yes Yes Yes Yes -11,41 Chain Technician Manager Yes Permanent Permanent Permanent Permanent Permanent Permanent Permanent Peniutnent Permanent No