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Group photo of participants of the Communicable Diseases.

Communicable diseases are a major cause of concern in low-income countries where poor education and awareness, unsustainable lifestyles, poor hygiene and sanitation, lack of palatable water and poor nutrition are contributing factors towards higher morbidity and mortality rates. Diarrheal Disease, Acute Respiratory Tract Infection (ARI), and Malaria, being most life threatening, are highly prevalent in many low-income countries.

These communicable diseases are recognized as very common in Afghanistan and have led to increased morbidity rates in the country in recent years. Since HMIS[1], recently reported that malaria, ARI and diarrhea are all highly prevalent diseases in the area that we work with under our PSMNCH[2], Community World Service Asia prioritized the training on communicable diseases for its nurses and midwives working at the project health centers. Awareness and techniques on diagnosing and preventing anemia, pelvic inflammatory diseases, STD (Sexual Transmitted Disease) and HIV were also included in the training. The training was conducted in two batches, one of six midwives and another of six nurses, of three days each in late August at the Laghman Public Health Directorate.

The training aimed at enhancing and refreshing the expertise of the midwives and nurses on communicable diseases, which would enable them in easily identifying, managing and referring patients to specialists and other hospitals. The trainings were led and facilitated by in-house experts on HMIS and Reproductive Health.

Participants of the training were briefed on the diagnosis and management of different kinds of diarrhea and on the symptoms and cure of dehydration. They were also provided with Integrated Management of Childhood Illnesses charts, which displayed the management processes of dehydration. The training ensured that all midwives and nurses were taught about the types, signs, complications and cure of malaria.

During the session on ARI, participants learned about the causes and preventive measures of common cold, pneumonia, sever disease, otitis, and pharyngitis. Participants further discussed the diagnosis and cure of ARI as per the National Standard Treatment Guideline (NSTG). Copies of the NSTG were also provided to the midwives and nurses. The session on anemia enabled participants to diagnose and control anaemia in pregnant and lactating women.

Guidelines including the National Standard Treatment guideline, malaria national treatment protocol and other MoPH[3] standard guidelines were shared with the participants, which would facilitate them during Out Patient Department (OPD) consultations.

Midwives and nurses were updated on new treatment and diagnostic protocols. Their skills and knowledge on clinical practices, existing gaps of diagnosis and treatment of common diseases were enhanced and made more effective.

Participants’ Voices:

The training was very useful for all of us. We largely learnt about common diseases. Anemia is much common among women of Ghaziabad. The training has equipped us with skills to provide efficient services to combat various disease, especially anemia. – Gulzai, midwife of Ghaziabad health facility.

Capacity building opportunities are always helpful for efficient work. We appreciate the opportunities provided to us, allowing us to stay updated with standard guidelines. This training has helped enhance our knowledge and skills on communicable diseases. I would recommend diverse training on other diseases recorded in the Health Management Information System reports. Gulrahman nurse of Shmam-o-Ram health facility.

I have visited several health facilities of Community World Service Asia and the quality of services has been improving frequently. These refresher trainings have contributed immensely in the proficient performance displayed by all the health staff at the health facilities. – Deputy Public Health Director of Laghman Public Health Directorate.

[1] Health Management Information System

[2] Partnership for Strengthening Mother, Newborn and Child Health project (PSMNCH)

[3] Ministry of Public Health

The health team was trained on new treatments to combat to malaria.

To ensure that the most deprived and vulnerable communities in the region receive the best kind of support, it is vital that the staff involved in humanitarian and development initiatives is well-trained. Community World Service Asia strongly believes and advocates for this and continues to provide and organize capacity strengthening and enhancement trainings for its staff and partners. As part of this resolve, we recently conducted two refresher trainings for our staff implementing our health project, financially supported by PWS&D[1] in Afghanistan.

The trainings were facilitated by the Laghman Provincial EPI[2] Management Team (PEMT) staff, Regional EPI team and EPI supervisor of Swedish Committee for Afghanistan (SCA).The first training was a six day course (from June 23rd – 28th) on Immunization programs which was participated by six Female Community Health Supervisors (FCHS), responsible for vaccination in the Maternal, Newborn and Child Health centers (MNCH) set up under the project. The aim of the training was to update the vaccinators on changes introduced in EPI guidelines and strategy on vaccines.

EPI is one of the core elements of a Basic Package of Health Services (BPHS) and is considered a priority activity that must be provided by all health facilities, of the Ministry of Public Health (MoPH) in Afghanistan. The six FCHSs were trained on providing vaccinations on ten preventable diseases, including Diphtheria, Pertussis, Tuberculosis, Tetanus, Polio, Measles, Hepatitis, Pneumonia, Flue and Diarrhea. The benefits, side-effects, dosages and schedule of administration of vaccination were defined and explained. During the training, the participants were thoroughly briefed on the EPI strategy and objectives and the various Health Management Information System (HMIS) tools. The health workers’ skills on providing new vaccines, its policies, and on the cold chain system and its reporting were further enhanced through this training.

Khatima, a FCHS at the Aziz Khan Camp health facility quoted,

We learnt about new available vaccines including the Rota virus and pneumonia vaccines. Our skills on giving vaccinations were improved and our knowledge on new changes made in the MoPH policy was developed.

The second training, held from June 26 to 28, 2018, focused primarily on malaria. The training refreshed the health team’s expertise and knowledge on the new treatment protocols and case management of malaria patients. Malaria is an endemic disease in Afghanistan which is more common in eastern provinces of Afghanistan. It is highly prevalent in Laghman province. In 2017, there was an outbreak of Plasmodium Falciparum (PF) and Plasmodium Vivax (PV) cases in catchment areas of PSMNCH health facilities. It was one of the top ten diseases reported by PSMNCH health facilities that required more focus on preventive measures. Based on the high prevalence of the disease there was a dire need to further strengthen the health staff’s capacities on its case management. The participants enhanced their skills on new treatments and case management of malaria, its diagnosis and its reporting.

The training was very useful and we learned how to diagnose and treat different cases of malaria. The new changes made in MoPH, regarding the treatment protocol, was informative and important for us to help perform better at our jobs. We have come to know new techniques on how to treat PF and we will continue to treat Malaria more effectively through the new learning we  have received at this training,

 shared Sami Ullah, Nurse at the Ghaziaba health facility.

Khushal, PEMT supervisor of Laghman, added,

The health staff is hard-working and wants to provide good quality health services to the people of Afghanistan. The training has helped cover the gaps identified in the last supervision visit conducted by the PEMT staff. Participants of the training have built a good understanding on new MoPH policies on vaccination and new treatments to combat malaria.

[1] Partnership for Strengthening Mother, Newborn and Child Health project (PSMNCH) is implemented in Afghanistan by Community World Service Asia, with the support of Presbyterian World Service & Development (PWS&D)

[2] Expanded Program of Immunization

DurationSep 01, 2017Feb 28, 2018
LocationNangarhar and Laghman of Afghanistan
Key Activities
  • Assessment, validation and identification of 1,155 IDPs and Undocumented returnees families in Laghman and Nangarhar provinces.
  • Conditional cash transfer 1st and 2nd trenches distribution at first and second phase of JPF project.
  • Post Distribution Monitoring (PDM) after 1st and 2nd trenches distribution.
  • Distribution of Non food items for targeted IDPs and Undocumented returnees families in targeted provinces.
  • Regular coordination meetings with DoRR, local authorities and community Shuras, UN-OCHA, SCI and DRC in timely manner during assessment and identification of targeted beneficiaries in targeted provinces.
Participants11,234 Individual

DurationJan 01, 2017Dec 31, 2020
LocationNangarhar and Laghman Provinces of Afghanistan
Key Activities
  • Disaster Risk Reduction project has been shared and coordinated at central, provincial, district and community level
  • In coordination with Afghanistan Disaster Management Authority (ANDMA), DRR project team selected two most risk prone districts in Nangarhar province (selection has been carried out based on risk assessment probability). After selecting the two most risk prone district, Project team has formulated two hazard map making team in the target district, consisted of communities (DDA and CDCs), district offices and provincial ANDMA
  • Capturing Risk: Under the project core activities, hazard map teams have provided with technical training on developing hazard maps and understanding different approaches on DRR. Both the teams have been taken to Japan for technical training in order to transfer technical know-how from Japan to Afghanistan. Hazard map teams have been also taken to DRR training which was held in Delhi India, the participants have been given a detailed training on using risk information and utilizing those information in saving lives.
  • Hazard and DRR Mapping: based on the training and transfer of technical know-how, hazard map teams along with project team developed hazard maps for the risk prone areas in two districts (there were 11 risk prone areas in the two districts for which hazard maps have been developed)
  • Risk Information Communication: Project Team has communicated the risk information with the relevant stakeholders including communities, district offices, central and provincial ANDMA offices, media, parliament, Institutions, academia etc…
  • DRR Awareness Raising Messages: Project team, in coordination and cooperation with CWSA communication, has developed DRR Awareness audio and video messages, which have been broadcasting and telecasting at zonal and central level (there were 5 audio and 5 video messages on flood and landslides)
  • DRR Awareness Tools: To nurture map reading culture in Afghanistan, Japan Conservation Engineers (JCE) developed a textbook, reader friendly and interesting, which is contextualized and translated in two local languages (Pastho and Dari), this book will be taught at community level in order to train them, how to read maps, importance of maps and some technical techniques for understanding different map parts. JCE has also developed Evacuation Activity Game (EVAG) for evacuation process, DRR project team has contextualized and translated into local languages (Pashto and Dari). This tool is basically designed to easily train the community people to understand evacuation process
Participants7,000 individuals

DurationMar 01, 2016Mar 31, 2020
LocationLaghman, Afghanistan
Key Activities
  • Establishment of 6 PSMNCH health facilities
  • Establishment of 23 health posts
  • Establishment of 6 Health center Committee
  • Establishment of 6 Village Safe motherhood Committee
  • Provision of OPD ( Out Patient Department) services to mothers, new born and children
  • Provision of MCH services ( ANC, delivery, PNC and Family Planning) to CBAs ( Child Bearing Age ) Mothers.
  • Provision of vaccination services to children and CBAs mothers
  • Provision of community and clinic based health education and awareness sessions
  • Capacity building of health facility staff via conducting several training sessions
  • Conducting training sessions to community on RH, SRH, family health, gender, personal and environmental hygiene and safe motherhood.
Participants53,963 Individual

DurationApr 01, 2013Mar 31, 2016
LocationNangarhar and Laghman provinces
Key Activities
  • Political and civic education summer camps for girls
  • Student-centered teacher training for teachers
  • Community awareness sessions on the importance of girls' education
  • Development of teacher resource centers
  • Establishment of playgrounds
Participants787 female students
1,089 teachers
620 parents
200 community members

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DurationJul 01, 2015Jun 30, 2017
LocationNangarhar, Laghman and Bamyan provinces
Key Activities
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  • Teachers Trainings on Pedagogical Skills
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  • Community awareness sessions on the importance of girls' education
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Participants1224 female students
789 teachers
453 community members
1643 PTC members/ Parents
40 Government Officials

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DurationJul 01, 2017Jun 30, 2019
LocationNangarhar, Laghman and Bamyan provinces
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  • Teachers Trainings on Pedagogical Skills
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  • Community awareness sessions on the importance of girls' education
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  • Establishment of playgrounds
Participants800 female students
460 teachers
450 community members
1680 PTC members/ Parents
80 Principals/Vice Principals
80 Government Officials

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My husband works as a laborer in a construction company in Iran. He earns a daily wage of AFN 500 (Approx. 7 USD). I live alone with my two sons and one daughter in Afghanistan,

shared Asma sadly. The mother of two sons and a daughter, Asma lives with her children in Mashinna village, located in Qurghaie district of the Laghman province in Afghanistan. Her husband sends her money on a monthly basis but his low income is insufficient to bear all the household expenses. Asma has hardly been able to save money for health care emergencies of her own or her children and with no health facility nearby, travelling to distant hospitals has been out of the question.

When Asma was pregnant with her third child, her husband could not stay till her delivery and had to fly back to Iran for work. Being alone and economically bound, Asma would have had no one to assist her during the delivery of her third baby. Fortunately, a lady Community Health Worker (CHW) came to her when she was in her third trimester and informed her about the maternal and neonatal health assistance provided in the Nowdamorra Sub-Health Center (SHC) which is located near to their village.  The health worker thoroughly examined her and prescribed her multivitamins and micronutrient pills. Asma was told about the safe delivery services and antenatal and postnatal care provided at the health facility and was then registered as a patient in the sub-health centre. She was advised to visit the health center regularly for antenatal care.

As a patient registered with the SHC, Asma received regular and quality antenatal Care throughout her last trimester. She came to the SHC for regular checkups and was prescribed micronutrient medication. A midwife at the SHC conducted health and hygienic sessions for Asma and other expecting mothers from the village and shared a suggested diet chart with them, advising them to eat food that was healthy and nutritious for them and their babies. Thus, Asma was well-informed on the prevention of risk factors during pregnancy and delivery.

In July 2017, Asma delivered a healthy baby girl with the assistance of a skilled midwife and nurse at the Nowdamorra health centre. Asma regularly visits the SHC for postnatal care where she receives family planning and breastfeeding sessions. In addition, she was also given a diet chart to follow for a period of six months postpartum.

The staff at the health facility is very cooperative and facilitated me timely resulting in the safe delivery of my beautiful daughter.

*The Nowdamorra Sub-health centre is among six sub health centres established in four districts of Laghman province in Afghanistan by Community World Service Asia and financially supported by PWS & D.

Facilitator from Health Net-Transcultural Psychosocial Organization (HN-TPO) training Community Health Workers on Controlling Malaria.

Under its’ Maternal Newborn and Child Health (MNCH) project in Afghanistan, Community World Service Asia conducted Community-Based Health Care (CBHC) trainings in across six of its sub health centers in the Badiulabad, Salingar, Shamuram, Ghazi Abad, Nawdamorra, and Surkhakan villages of Laghman province.  The trainings took place between 15 November to 9 December, 2017 and were attended by 23 men and 23 women Community Health Workers (CHW) in the target areas.

The main objective of these trainings was to train CHWs to provide quality primary health care services that would lower mortality and morbidity rates in the catchment areas. This goal was divided into three main targets:

  1. To enhance the target community’s access to primary health care services
  2. To enhance mothers’ access to MNCH service es, such as safe deliveries
  3. To enhance the community’s knowledge about disease prevention

A Female Community Health (FCH) Supervisor and male nurse from each sub health center facilitated the training in their respective health facilities. They training focused on teaching staff about:

  • Common disease, definition, signs and symptoms
  • Causes of common diseases
  • Diagnosis and treatment of common diseases
  • Rational prescription

Additionally, the CBHC curriculum was shared with the participants which covered various health topics regarding preventive and curative care. Description, diagnosis, treatment and medicines for common diseases have been explained in the curriculum.  Moreover, it includes prescription of various medicines and their side effects.

Participants in the training were taught on how to conduct health education at community level. In order to improve their prescription writing skills, they were trained on dosage and side effects of each medicine. The training enabled the CHWs to prescribe medicines based on the CBHC curriculum discussed with them during the training sessions.

Since Laghman province is an endemic area for malaria prevalence, in the last week of the training, a two-day session on malaria was coordinated with Health Net-Transcultural Psychosocial Organization (HN-TPO) who have extensive experience on Community Based Management of Malaria (CBMM). The session enabled the CHWs to properly diagnose, treat and refer malaria cases. During the CBMM session, the health workers were coached and were given time to practice their skills during the sessions; this included collecting blood samples, making slides, testing strips, and prescribing medicines to patients. Specific guidance on the Rapid Diagnostic test and how to prescribe a malaria positive patient using the Arthesoinate Combine Therapy (ACT) was also given. These skills learnt at the trainings were essential for the community health workers in providing high quality health services to vulnerable communities as they visit house after house.