Field visit to assess the potential of eHealth in Afghanistan

Rustam Nabiev and Karoline Beronius were invited by the Swedish Committee for Afghanistan (SCA) to carry out a short feasibility study in Afghanistan. The purpose was to investigate the opportunities to improve the data management and information within the SCA health program in order to improve health service delivery and follow-up.

At the beginning of March, the two experts held consultations with SCA Kabul Management Office (KMO) staff, Wardak Project Office staff, Ministry of Public Health and Ministry of Communication and Information Technology and visited clinics and hospitals in Kabul and its surroundings.

In 2001, Afghanistan had some of the worst health indicators in the world. There was a lack of structure, infrastructure, human and financial resources to support health service delivery. Afghanistan is a mountainous country with a large rural population. Many did not have access to health services at all.

The Ministry of Public Health has taken a systematic approach to health service delivery with focus on especially vulnerable groups, i.e. women and children. The Ministry of Public Health collaborates with different partners on the delivery of Basic Package on Health Services (BPHS) and Essential Package for Hospital Services (EPHS). SCA is responsible for the delivery of health services in four provinces. Naturally there are many challenges and despite a clear and inclusive vision health services do not reach all.

But, the efforts are beginning to pay off; Afghanistan has made tremendous improvements in a short period of time. In only 10 years, life expectancy is beginning to creep upwards, under-five mortality has decreased significantly by around 25% and maternal mortality has been more than halved.

In addition, the Ministry of ICT has developed a modern communications infrastructure in the country, providing 90% of the population with mobile network coverage

Rustam and Karoline presented the findings at the SCA Kabul Management Office (KMO) and shared experiences from developing low-cost medical technology and implementation of health information management systems in other low-resource settings.

Low-cost technology such as the mobile phones is used to follow up child immunization through the Shifo outreach vaccination system.  Mobile phones and computers integrated with low-cost medical technology can provide cheaper alternatives to expensive diagnostic equipment.

One of the most recent projects -ICT4MPOWER- involved the development of an open source healthcare information management system. The system including applications supporting electronic health records, laboratory, drug and stock management, and HR has been implemented at a health facility in Uganda and is running successfully since March 2012.

It was concluded that there is good potential for strengthening public healthcare in Afghanistan through the application of ICT. Naturally, there are still many challenges, but there seems to be a systematic approach on which eHealth solutions can further strengthen health service delivery and extend service provision to those who cannot access it. The rolling out of ICT is rapid and strategic.