Afghanistan

The Health Sector Transition Strategy (HSTS) 2023–2025 outlines Afghanistan's efforts to sustain and enhance its healthcare system amid ongoing challenges. Developed by WHO, UNICEF, and partners, the HSTS identifies strategic priorities to address gaps in health coverage, financing, and system resilience post-2021. It builds on the National Health Policy (NHP) and National Health Strategy (NHS), which were interrupted by political upheavals. The strategy highlights progress made over two decades, including the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS), but notes these are outdated and underfunded. Efforts to implement the Integrated Package of Essential Health Services (IPEHS) have stalled. The health system heavily relies on international aid, with 77% of health expenditures covered by out-of-pocket spending, creating financial barriers for the population. Challenges include limited access in remote "white areas," low health workforce density, and inadequate representation of female healthcare providers due to sociopolitical restrictions. Quality of care remains compromised by insufficient infrastructure, staffing, and medical supplies. Governance disruptions and the unclear role of de facto authorities exacerbate these issues. The HSTS focuses on expanding essential health services, enhancing emergency response, and harmonizing financing. Off-budget mechanisms continue to fund health services through NGOs and UN agencies, sustaining critical care delivery. The strategy underscores the need for strengthened collaboration, efficient resource allocation, and targeted interventions to address Afghanistan's evolving disease burden, including non-communicable diseases, malnutrition, and mental health challenges. Despite its ambitious vision, Afghanistan's healthcare faces significant barriers in achieving equitable, high-quality service delivery, especially under a constrained political and economic environment.