Establishing a quality healthcare system in Afghanistan has been an ongoing challenge, as the country has been dealing with issues such as drought, a constantly changing political system, and a struggling economy. For years, many healthcare services, particularly emergency medical care, were provided by the military and non-governmental organizations. Problems have persisted, including poor conditions at medical facilities and a lack of access to hospitals, clinics, and doctor’s offices. Now, however, Afghanistan aims to encourage increased international investment in its healthcare system.
In March 2019, Afghanistan officials announced that an Afghan health organization had partnered with three Indian companies as part of a $6.5 million deal, which will help to build a diagnostic center, a pharmaceutical manufacturing plant in Kabul, and an advanced dialysis center.
Strengthening the Medical Infrastructure
Officials hope that strengthening Afghanistan’s medical infrastructure will reduce the number of Afghan residents who travel to other countries for medical care. It’s estimated that Afghans spend about $285 million each year on treatment abroad in locations such as India. One Afghan ambassador to India has estimated that about 70 percent of the Afghan visitors are “medical tourists” who see physicians for everything from heart problems to gynecological conditions.
According to a news report in 2013, many Afghan medical tourists visiting India reported that in Afghanistan there are often inadequate medical facilities. Many Afghans place Indian physicians in high regard and will expend the extra effort and expense to travel to India for care, as they say Indian physicians use more advanced medical treatments. In turn, Indian hospitals have provided training programs for Afghan medical professionals.
Encouraging Private Investment
The new partnership with Indian companies is part of the Afghan government’s focus on strengthening private-sector investment in Afghanistan’s health care sector. The groups first spoke in 2018 at Passage to Prosperity: India-Afghanistan Trade and Investment Show, where Afghan officials said they welcomed outside investment in their country’s healthcare system, particularly from India.
“The private health sector is an integral part of Afghanistan’s health system and plays a crucial role in meeting the demands of Afghans for healthcare,” Afghanistan Minister of Public Health Ferozuddin Feroz said at the meeting. “The partnerships between the Afghan health businesses and Indian organizations that we witness today will help fill the gap in service delivery in the country.”
Officials also recognized that boosting investment in healthcare would positively impact Afghanistan’s economic growth by creating jobs and a more skilled local labor force.
Ongoing Issues
One major issue that Afghanistan continues to grapple with is a lack of access to healthcare for many of its citizens. In 2017, Lancelot Global Health published a report that examined how Afghanistan’s healthcare system was faring 15 years after international investment in it. The study found that between 2004 and 2014, access to quality care “decreased significantly,” according Jean-Francois Trani, the study’s lead author.
The study was conducted twice at households in 13 Afghan provinces: once in 2005 and then in 2013. The surveys asked household members questions about socioeconomic factors, how they perceived the availability of healthcare, and any experiences they had with trying to have their healthcare needs met. In the second study, 25 percent more people said that healthcare was not available, and 32 percent more said that they had a negative experience with healthcare needs coverage.
Even travel time to healthcare facilities worsened over the time that the study was conducted. In 2013, respondents reported that people with disabilities required more time to travel to a healthcare facility and that the ability to travel there on paved roads had become more difficult.
The report recommended several interventions, which included promoting community-based healthcare, educating people about hygiene and disease prevention, concentrating on treating common childhood illnesses and communicative disease such as malaria, and making reproductive health advice more available.
A Wider Range of Quality Care
At the same time, NGOs continue to bring healthcare to rural areas and offer a wider range of quality care. A 2018 report from the World Bank noted that child and maternal mortality rates have decreased significantly since 2003, and maternal care and immunization had greatly improved. The number of healthcare facilities in Afghanistan increased from 500 to 2,500 between 2003 and 2018, according to the World Bank.
Much of these gains came during periods of unrest in Afghanistan, the World Bank noted. Officials believe this success is due in part to a move away from a system of “scattered” basic health services provided in rural areas by international NGOs that rarely coordinate with each other. After 2003, the Afghan government worked with NGOs to take responsibility for specific geographic areas and to provide a government-defined set of healthcare services. As the years went by, more national healthcare providers began offering services, reducing the number of international organizations involved.
The World Bank recognized that the key to ongoing success in Afghan’s healthcare system involved the government continuing to specify a basic package of healthcare services that providers should offer and partnering with NGOs and other organizations. Local and international investment will bring the private sector into Afghanistan’s healthcare system, which officials hope will continue to expand its reach and provide increasingly better care.