Afghanistan is a mountainous landlocked country in Central Asia with a rich history and culture that goes back 5,000 years. The country has remained in conflict over the last three decades and is now striving to recover. The country’s current health and nutrition situation indicates that progress toward achieving its developmental goals is relatively slow.

The nutritional status of children under five continues to deteriorate in most parts of Afghanistan, directly threatening their lives. This stems from the surge in acute food insecurity over recent years combined with other contributing factors such as low access to health services (due to forced displacement or issues with physical accessibility and distance to nutrition services), poor access to water and sanitation, poor maternal nutrition, low immunization coverage, and high disease burden.

Poor feeding practices for infants and young children are also strongly linked with undernutrition. Although almost all children in Afghanistan are breastfed, only 58 percent of children under six months are exclusively breastfed. In a deteriorating trend from the beginning of the year, the most recent nutrition surveys show that 26 out of 34 provinces are above the emergency threshold for acute malnutrition. Analysis of data from 50 SMART surveys conducted from 2015 to 2019 indicates that a staggering 15.3 percent of infants under six months in Afghanistan were affected by wasting. Of these children, some 6.2 percent are severely wasted. The increasing trend in the number of children affected by acute malnutrition each year, with a significant deterioration during 2020, indicates that tackling malnutrition remains one of Afghanistan’s fundamental challenges and continues to impact the lives of far too many young children.

In the revised HRP 2020 (June), the Nutrition Cluster has identified 4.63 million children and women needing emergency nutrition assistance to avoid preventable health complications, morbidity, and mortality. This was a 38 percent increase in needs since the start of the year.

Throughout 2020, some 783,583 children under five were projected to have Severe Acute Malnutrition (SAM); 2.11 million children were projected to have Moderate Acute Malnutrition (MAM). Additionally, 650,438 acutely under-nourished pregnant and lactating women (PLW) were in need of a Targeted supplementary feeding program (TSFP). A further 435,445 children under five, 232,877 PLW, and 414,534 mothers and caretakers were also estimated to be nutritionally ‘at risk.’ Of these people in need, the COVID-19 pandemic is estimated to have pushed an extra 106,214 children under five into SAM, some 284,688 children under-five into MAM, and some 87,298 under-nourished PLW to require life-saving treatment and nutritional support. About 85 percent of acutely malnourished children under five were in 26 high-priority provinces.

Besides poor health and nutrition, Afghanistan is also facing other daunting development challenges. Rapid reduction in international grant support, loss of access to offshore assets, and disruption to financial linkages are feared to lead to a significant contraction of the economy, increasing poverty, and macroeconomic instability. WASH needs of the communities are also significant, particularly in those areas where the infrastructure has been damaged and the population, particularly women, have limited access to WASH infrastructure.

Afghanistan faced daunting economic and development challenges even before the government’s collapse. Afghanistan’s economic growth was slow up to August 2021, reflecting weak confidence amid a rapidly worsening security situation and severe drought conditions negatively affecting agricultural production. In addition, Afghanistan experienced a third COVID-19 wave, where the infection rates have reached record highs, with less than five percent of the population fully vaccinated.

This Expression of Interest aims to provide a full package of community resilience in Afghanistan through an integrated approach. SAW International aims to initiate tailored area-based programming for integrated socio-economic recovery along with health, nutrition, WASH, and social protection initiatives for community resilience as a rapid response to the current crisis in Afghanistan.

Approach,

The affected population is exposed to multiple challenges; the vulnerable women and children are in dietary needs, malnutrition and lack of food are evident on their faces, clean drinking water is not available as per sphere standards, open defecation is common, hygiene is not maintained, children, adolescent girls, and women are at risk, the worst condition has traumatized the vulnerable population. They are in intense need of external support to address their problems.

Goal;

The broader goal of this intervention is to assess the priority needs and initiate area-specific need-based interventions in different conflict-affected provinces of Afghanistan.

Specific Objectives

• To conduct a Rapid Need Assessment to prioritize dire needs in different provinces.
• To provide emergency support for health, nutrition, WASH and social protection, and community livelihoods through an area-specific approach.
• To strengthen the coping mechanism of making them resilient to future shocks cost-effectively and sustainably.

PROPOSED ACTIVITIES

Social Behavior Change Communication

• Formation of Community Support Committees (male & Female).
• Orientation of Community Support Committees on Health, Nutrition, Child Protection, MHPSS, and WASH.
• Broad-Based Community Meetings on awareness raising (BBCMs).
• Development/ Documentation (if available) of critical messages regarding health, nutrition, WASH, and CP.

The Need

SAW works and plans on a short and long-term fundamental solution Integration of the proposed sector-wise activities will be highly beneficial as all one approach will facilitate the conflict-affected population in one widow assistance, and they will not seek help from multiple services providers. SAW International already has implementation experience in all thematic areas and previously implemented health, nutrition, protection, and WASH-integrated projects with the support of donors. Therefore, we are pretty optimistic about delivering this integrated package of services.