Conducted by World Bank experts and an independent group from the University of Toronto, the review found that many key health indicators had improved more rapidly in Afghanistan than in most other countries that had started at a similar level of development. The under-5 mortality rate dropped 60 percent from 137 per 1,000 live births in 2002 to 55 in 2016. Births attended by skilled health personnel increased to 58 percent from 14.3 percent over the same period. Announcing these results at a Presidential Summit on Health Care in Kabul, Dr. Timothy Evans, Senior Director for Health Nutrition and Population at the World Bank said, “The progress made in Afghanistan is impressive, especially given the serious security situation the country has faced over the last decade. Afghanistan has set a new benchmark against which to judge other countries affected by conflict, and even more so low income countries that are not facing conflict.” These improvements are consistent with those observed in the quality of care and equity in access to services, and the large increase in the number of health facilities. The number of functioning health facilities increased five-fold over while the proportion of facilities with female staff increased from 22 percent to 87 percent. The review noted that the government’s contracting of nongovernmental organizations (NGOs) to provide health services has led to improvements in coverage and quality, even in provinces that had high levels of conflict, suggesting substantial resilience of the health care system.
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