Afghanistan

Summary of needs

Afghanistan continues to experience multiple shocks including outbreaks of communicable diseases, floods, drought, earthquakes (affecting 22 health facilities and killing more than 2,200 people) and over 2.5 million returnees in 2025 only¹. These disasters put strains on the weak, fragile, and unequally distributed health care services with 33% of the population living in underserved areas². The healthcare system faces numerous challenges, including inadequate funding, heavy reliance on foreign aid, shortage of healthcare professionals, and limited access to essential quality reproductive health care, especially for women and children in remote and underserved areas.

In 2025 the access to health care was further compounded by the closure of at least 422 primary health care facilities including Mobile Health and Nutrition Teams (MHNT) due to stop funding from the US government and other donors, this closure affected access to estimated 3.3 million people.

As of epi-week 45 of 2025, surveillance data from 613 sentinel sites reported 151,451 cases of Acute Watery Diarrhea with dehydration, 74,253 of malaria, 95,019 of measles, 4,384 of dengue, 1,438 of Crimean-Congo Hemorrhagic Fever, and nine cases of poliovirus type 1³. Malnutrition remains high with 3.5 million children suffering from acute malnutrition⁴. The disruption of facility based maternal delivery services and family planning poses a critical threat to maternal and neonatal health services while limited access to safe water and sanitation continues to drive morbidity and mortality. Seasonal variations further exacerbate health risks, with respiratory infections peaking in winter and waterborne diseases rising in summer.

The most severe health needs are concentrated in underserved areas and among vulnerable groups, including women, children, displaced populations, and persons with disabilities. Over the past year, these needs have intensified, underscoring the urgency of strengthening health infrastructure, expanding service access, and ensuring targeted support.

Response strategy

In 2026, the Health Cluster will prioritize expanding equitable access to primary healthcare services in hard-to-reach and underserved areas, strengthening referral pathways, and enhancing disease surveillance, preparedness, and response capacities. Key focus areas will include the delivery of essential health services, with particular emphasis on minimum initial service package (MISP) for reproductive health, antenatal care, safe deliveries, post-natal care, and family planning, trauma care for injuries resulting from conflict and natural disasters, rehabilitative services, and targeted support for people with disabilities and other vulnerable groups.

Service delivery will be implemented through a combination of fixed and supported health facilities and MHNTs deployed to remote and high-need locations. These teams will be equipped with essential medicines, including reproductive health commodities, medical supplies, trained health personnel, and transportation to ensure continuity and quality of care.

The response will prioritize the most vulnerable populations, including women, children, persons with disabilities, the elderly, internally displaced persons, returnees, and those affected by natural disasters particularly communities residing more than five kilometers from the nearest functional health facility.

Health Cluster interventions will complement BHN efforts by addressing immediate and life-saving health gaps while promoting linkages to longer-term. Given the absence of BHN or donor plans to expand health infrastructure in remote areas, MHNTs will remain a vital interim mechanism for service delivery until permanent health facilities can be constructed and integrated into sustainable care systems.

Targeting and prioritisation

The identification of the population in need and targets was based on severity classification using 10 indicators. 159 districts in severity classification 4 and 195 districts in severity classification 3 were selected based on access to health care including for women and children, health service coverage, health status of the population, incidence of epidemic prone disease (Acute Watery Diarrheal disease with dehydration, malaria, measles, Acute Respiratory Tract Infection, Crimean Congo Hemorrhagic Fever, and Dengue) and population vulnerability (malnutrition, poor maternal health outcomes and access to safe water).

The People in Need (PIN) for the HNRP 2026 is 14.4 million, with a target to reach 7.21 million in consideration of defunding issues, individuals, of whom 23.8% are women, 54% are children, 46% are adults, 2% are elderly, and 10% are people with disabilities.

If only 50% of the required funding is received, priorities will be given to strengthening selected primary health care services in the most underserved districts and Health Cluster will prioritize lifesaving including maternal and neonatal care and outbreak response activities, reducing support to health facilities and MHNTs, and suspending rehabilitation and trauma services in lower-priority areas. Consequently, an estimated 3.6 million people mainly women, children, and persons with disabilities will miss out on essential healthcare services.

Promoting accountable, quality and inclusive programming

The Afghanistan Health Cluster conducted a PSEAH and GBV survey and developed an action plan focused on partner capacity building, gender equality, and survivor-centered services. Risk assessments for PRSEAH, gender, and GBV were integrated into emergency responses, including for returnees, earthquakes, AWD outbreaks, and floods. GBV risk mitigation includes ensuring confidential access to clinical management of rape (CMR) services, including post-exposure prophylaxis (PEP) and emergency contraception, as part of minimum initial service package for reproductive health.

Frontline health workers received training on safe reporting, referral, and handling of SEA cases using PSEA SOPs. SEAH monitoring was strengthened at both facility and organizational levels to track risks and ensure implementation of PSEA core standards.

Cluster members supported community outreach through health staff, risk communication, and health promotion. Engagement with communities was enhanced via health shura advocacy meetings. High-level advocacy with country directors and training on integrating PRSEAH, gender, and GBV into proposals also took place.

Cost of response

The Health Cluster’s cost estimates for primary health care services are based on unit cost per consultation and for other services are unit cost per patient. For MHNTs, the unit cost of running an MHNT was per year. The detailed cost breakdown is as follows:

• Primary healthcare at static facilities: $129,935,916 million
• Primary healthcare through Mobile Health and Nutrition Teams (MHNTs): $15 million
• Essential secondary care services for referrals: $15,014,792 million
• Disease outbreak preparedness and response: $28 million
• Risk Communication and Community Engagement (RCCE) activities: $2,250,000 million
• Specific services for survivors of violence and disability rehabilitation: Included within total cost

The total projected cost for comprehensive healthcare interventions across targeted regions is $190.8 million.