JSDF Provides $17.9 million to Co-finance Provision of Basic Health Services in Afghanistan

March 14, 2010

KABUL, 14 March 2010 – The Ministry of Finance, Islamic Republic Afghanistan and the World Bank, today signed an agreement of $17.9 million grant to co-finance the ongoing Strengthening Health Activities for the Rural Poor (SHARP) project. The grant resources are being made available by the Japanese Social Development Fund (JSDF), a World Bank managed trust fund financed by the Government of Japan.
The SHARP project supports Afghanistan’s Health and Nutrition Sector Strategy, outlining government's commitment to ensure improved access to basic health care 2008-2013.  The project will support the Ministry of Public Health (MoPH) plan to expand coverage of the Basic Package of Health Services (BPHS) to at least 90 percent of the population by the end of 2010.

“Despite substantial challenges, the Government has made remarkable progress in providing basic health services to millions of Afghans throughout the country,” said HE Dr.  Omar Zakhailwal, Afghan Minister of Finance (MoF).   “Afghans even in most inaccessible and insecure areas have benefited from provision of basic package of health services.  We are grateful to the people and the Government of Japan for providing funds to achieve that aim.”

Afghanistan has made significant progress in the health sector over the last seven years. The National Risk and Vulnerability Assessment 2007/08 indicated good progress in reducing infant and under-five mortality.  Infant mortality declined from 129 live births in 2006 to 111 in 2008 (per 1000 live births), representing a 13 percent reduction. Similarly, under five mortality declined from 191 to 161 per thousand live births (15 percent reduction) in the same period.

Health care for expectant mothers expanded, with the number of deliveries assisted in facility by trained health workers jumping from 6 percent to 24 percent. The number of pregnant women who received at least one prenatal care visit rose from 11 percent in 2004 to 36 percent in 2008. Child immunization rates are still low but have improved from 12 percent in 2005 to 33 percent in 2008. Around 20,000 community health workers—half of them women—have been trained and deployed throughout the country, increasing access to family planning and boosting childhood vaccinations. The number of facilities with trained female health workers rose from 25 percent before the project to 74 percent today.

Japan has set a high priority on the assistance to health sector in Afghanistan.  I would like to express our deep appreciation for the excellent work of Ministry of finance, Ministry of Public Health and World Bank in our joint efforts to improve the quality of health service in this country,” said HE Shigeyuki Hiroki, the Ambassador of Japan to Afghanistan.

Currently the Basic Package of Health Services through SHARP project has been provided to the rural population in 11 provinces. There is, however, large population living in urban areas that do not have proper access to primary health care.  Therefore, the JSDF covers not only rural areas in Balkh and Samangan Provinces, but also urban area of Kabul Province. The support for urban Kabul is going to be provided under the close cooperation with “the Urban Health System Strengthening Project”, which has been conducted by MoPH and the Japan International Cooperation Agency (JICA).

“Over the past seven years, MoPH has taken steps necessary to ensure availability, accessibility and quality of health services,” said Ms. Josephine Bassinette World Bank Acting Country Director for Afghanistan.  “There remains, however, a long way ahead to further improve quality of primary health care and do more for improving overall health services throughout the country.  The international community should recognize and applaud the role of non-governmental organizations (NGOs) over the past seven years. Utilizing NGOs as service providers proved to be an effective way of reaching the Afghan National Development Strategy goals.”

The project will be implemented by MoPH over a three year period. The World Bank’s ongoing SHARP project since March 2009 is a $30 million grant with an additional financing of $11 million grant from multilateral sources.  In addition, the Bank is working on accessing additional funds from Afghanistan Reconstruction Trust fund for the project.  An earlier Bank financed Emergency Health Sector Reconstruction project of $120 million was completed in June 2009.

Note to editors:
The JSDF was established by the Government of Japan in 2000 as a means of supporting activities which directly respond to the needs of poor and vulnerable groups, enhance their capacities, and strengthen their empowerment and participation in the development process. The fund is administered by the World Bank. The Government of Japan and the World Bank agreed to set up a special window within the JSDF to support activities in Afghanistan under a multi-year program of assistance for the country’s reconstruction and transition toward political, economic, and social stability.  So far, approximately 80 million US dollars have been disbursed to various projects to meet the basic needs in Afghanistan through JSDF.