People in Need with funds from the EU supported 68,770 people in improving public health in central Afghanistan

Published: Jul 24, 2023 Reading time: 7 minutes

Families in the Jaghatoo, Behsood, and Saydabad districts in Wardak Province, central Afghanistan, face complex public health challenges, including increasing malnutrition and diminished capacity to practice good hygiene, as well as reduced coping mechanisms and resilience to deal with these challenges by themselves. As a consequence, the most vulnerable families are paralysed in their capacity to survive. During one year-long multi-sectoral intervention, People in Need, with humanitarian aid funding from the European Union, helped prevent the worst public health outcomes driven by the collapse of government services, contracting economy and effects of climate change, including drought and floods.

People in Need delivered a multi-sectoral response that supported the most vulnerable families in meeting their basic needs and building their resilience by providing cash-for-food assistance, nutrition support and WASH interventions in the affected communities.

Cash distributions to improve nutrition and support the local economy

Mohammad Gul (60) is a cobbler in Saydabad district in central Afghanistan. He works in the open beside a public road earning an average of 100 Afghani ($1.40) per day. "Before receiving cash, I borrowed money and food from my relatives and shops to provide food for my family because we had no food. My five-year-old grandson suffers from malnutrition," says Mohammad. Households were assisted with cash assistance to help them cover their basic food needs and tackle malnutrition. The support ranged from one to five rounds of cash-for-food assistance, depending on their vulnerability.

"I have received two rounds of cash assistance [AFN equivalent of $96 each]. I bought flour, oil, spaghetti, meat, beans and powdered milk for my family and grandson facing malnutrition. Now, we have access to some food, and my grandson's health has also improved–this money assisted me a lot during this difficult time," says Mohammad.

People in Need distributed cash-based food baskets to 25,902 people (3250 families), which had favourable and multiplier effects. Distributing cash aid has also enhanced people's purchasing power and positively influenced the local market and economy. “A long-term infusion of money into the communities boosted the local market, including sellers, market stalls, and importers,” says Najeebullah Mir, People in Need’s Programme Manager.

More children with malnutrition are treated

Within the EU-funded intervention, People in Need also conducted large-scale screening campaigns to identify malnourished children and mothers, and increased the number of cases of malnutrition treated by strengthening referral systems and health facilities.

In total, PIN’s Hygiene and Nutrition Promoters, and Outreach Community Health Workers recruited from the target area screened 6,549 families for malnutrition, and referred children and mothers suffering from malnutrition to the nearest clinics for support. The PIN team also provided the families with identified and referred cases with follow-up home counselling, and 3,300 families received Mid-Upper Arm Circumference (MUAC) strips, a quick way of identifying children at risk of malnutrition.

Rehabilitation of water sources to minimise water-borne diseases

Additionally, People in Need has increased the availability of drinking water by rehabilitating water sources. Altogether, 50 wells and 9 karez (traditional underground water channels) were rehabilitated by employing local people (both skilled and unskilled) who received wage for their work.

"We have many difficulties with drinking water. A flood hit our village and damaged the karez, then recent droughts dried up the wells," says Amir Jan from Gadayee village and adds that they were taking water by donkeys from another village 5-6 kilometres away. People in Need and locals organised the rehabilitation of a karez that serves 436 families by employing local skilled and unskilled labour. "I am so thankful to PIN for creating job opportunities for us. I can use the cash I received to cover my expenses. I can buy rice, oil and flour," says Amir Jan, who adds that if the work is successful, the water level rises will fulfil the villagers' water needs.

Additionally, 19 water and sanitation committees were established to increase local ownership and ensure sustainability of the rehabilitated water sources. 162 people from the supported communities became members of these committees. The committees received training, tools and spare parts to maintain the water sources after the end of the project.

Hygiene kits and awareness help to improve public health

People in Need also organised hygiene and nutrition awareness sessions for 79,567 people (11,368 families) and distributed hygiene kits to 22,918 people (3,274 families), most of whom were also supported with cash-for-food assistance.

“Before [receiving the hygiene kits], we shared hygiene items amongst many people, one towel was used by two or three people, the same for toothpaste as we couldn't afford one each,” describes Shakeeba Amiri the situation before People in Need came to support the village. “I received a hygiene kit, and inside the kit, there were 2 jerrycans, one bucket, a jar, a towel, sanitary pads, handwashing soap, laundry soap and a soap case,” says Shakeeba Amiri.

“We learned how to take care of our personal hygiene and make proper use of the kit, how to remove waste, store it properly and keep our places clean. As most diseases come from polluted environments, we must use safe latrines and cover the windows with nets. There must be water and soap in the toilet, we have to wash our hands after defecation, the latrine must have doors and windows, and the areas around our house must be clean,” Shakeeba describes what she learned during the hygiene promotion session.

To further reduce health risks, PIN in the target areas provided 100 community space cleaning kits to clinics, schools, mosques and market spaces, constructed 7 sets of public latrines, and conducted hygiene awareness sessions in the communities.

Shakeeba, an example of a multi-sectoral approach success

“When the PIN nutrition team measured my daughter's Mid-Upper Arm Circumference (MUAC), they observed that she was malnourished, then they referred her to the clinic, and I visited the clinic for three months and received ready-to-use therapeutic food for her. Right now, she is fully recovered—her MUAC, weight, and height are normal,” says Shakeeba Amiri. “We learned about the causes of malnutrition and that we must provide nutritious and healthy food to our children. Also, we learned that breastfeeding is the most essential thing for a newborn child. I received the family MUAC tape and learned how to use it. Now, every 15 days, I measure our children's MUAC,” Shakeeba explains what she learned in hygiene and nutrition awareness sessions.

“PIN's hygiene and nutrition team has taught us that we must eat fruits, vegetables, dairy, and other nutritious foods enriched in vitamins. With PIN's cash assistance, we could buy some vegetables and fruits, but when the money was spent, we took vegetables and fruits from our local farms,” Shakeeba explains her plans how to keep her daughter healthy in the future. Safe drinking water is an essential part of a future without disease.

“When PIN came, they rehabilitated our well, installed a hand pump, and covered it,” she says about the repaired water pump just a few metres from her house.

Najeebullah Mir, PIN’s Programme Manager, summarizes the advantages of the multi-sectoral approach applied, “The Wardak province, like other high-need and previously hard-to-reach areas in Afghanistan, faces multiple challenges such as food insecurity, access to safe and sufficient drinking water, health hazards including increase in the rate of malnutrition cases, and lack of knowledge of good hygiene and nutrition practices. In order to have an impact and build the resilience of the communities, all the challenges people encounter in a certain community need to be addressed comprehensively. The multi-sectoral approach has proven to be the best solution for the most vulnerable families in Wardak province.”

People in Need in Afghanistan

People in Need has been continuously operating in Afghanistan since 2001 and currently has 132 staff, most of whom are local employees. Currently, our work in Afghanistan focuses mainly on humanitarian assistance. We look at what package of immediate support households need, understand the root cause of this need, and provide assistance that, where possible, responds to both; building families’ resilience to withstand further shocks. With this view PIN focuses efforts to ensure supported families have: (1) enough to eat, (2) a safe and secure life that supports their health, well-being and rights, (3) the basic items needed to stay safe and warm, (4) adequate water and sanitation that reduces individual and public health risks, and (4) access to education when the normal structures are no longer available to them.

About EU Civil Protection and Humanitarian Aid

The European Union and its Member States are the world's leading donor of humanitarian aid. Relief assistance is an expression of European solidarity with people in need worldwide. It aims to save lives, prevent and alleviate human suffering, and safeguard the integrity and human dignity of populations affected by natural disasters and man-made crises.

Through its Civil Protection and Humanitarian Aid Operations department, the European union helps millions of victims of conflict and disasters each year. With headquarters in Brussels and a global network of field offices, the EU assists the most vulnerable people based on humanitarian needs.