Improving health and nutrition in Afghanistan

After almost 10 years, we made the challenging decision to close our office in Afghanistan. With exceptional commitment and the highest caliber of effort, our team made a difference in the lives of some of the most vulnerable populations in some of the hardest to reach areas.

We are proud of our colleagues, in the partnerships established and the impact made over the many years of operation.

Nutrition International’s efforts in Afghanistan

Since 2007, Nutrition International, formerly the Micronutrient Initiative, has worked closely with the Ministry of Public Health (MoPH) and other partners on the ground to improve the nutritional status of the people of Afghanistan.

With financial support from the Government of Canada, we focused our efforts on key priority interventions to improve the health of the most vulnerable – especially women and children – by helping to create access to the vitamins and minerals they need to survive and thrive.

Key to our efforts in Afghanistan was to support the capacity building of the Public Nutrition Division (PND) officials in the MoPH, at both national and provincial levels.

Starting in 2009, where we supported the MoPH to develop a micronutrient strategy, we have worked together for improved planning, monitoring and management of nutrition programs, especially micronutrient programs, with a focus on improving data collection, data management and monitoring for corrective actions.

This work included the placement of a national Micronutrient Officer within the PND-MoPH, starting in 2011, which was important to ensure nutrition remained a priority. More recently, Nutrition International supported the MoPH to revise the Public Nutrition Strategy and Policy for Afghanistan – based on new evidence, existing nutrition and health policies and plans of the Government of Afghanistan – to guide the country’s nutrition agenda.

Want to learn a bit more about what was accomplished? The tabs below provide a snapshot of our work.

Boosting immune systems

Since 1999, through our vitamin A In-Kind-Assistance program, we have ensured the delivery of high quality vitamin A capsules to support the implementation of the Vitamin A Supplementation (VAS) Program, an integral part of child survival programming.

Annually, approximately 4.4 million children below the age of five have benefited from this program. Further, as a member of Afghanistan’s National Working Group for VAS, Nutrition International has contributed to the national planning for VAS program.

Treating childhood diarrhea

With Nutrition International’s support, the use of zinc and ORS to treat childhood diarrhea has been greatly strengthened in Afghanistan, including the scale-up with public and private sector components across 13 provinces.

As a member of the Government of Afghanistan’s Zinc Working Group, Nutrition International worked to improve specifications for procurement of zinc supplements; train public and private sector service providers; promote awareness among caregivers; strengthen delivery mechanisms; and improve monitoring and supervision.

Highlights from our work include:

  • completed demonstration projects in 10 districts of two provinces from 2011 to 2014, which helped to treat approximately 300,000 episodes of childhood diarrhoea with zinc and ORS.
  • 100,000 courses of high-quality zinc and ORS were procured and distributed through the Basic Package of Health Services (BPHS).
  • we helped reach more children in urban areas by training 2,500 private practitioners and pharmacists in five cities on the use of zinc and ORS to treat childhood diarrhea, as per updated World Health Organization guidelines.
Better infant and young child feeding practices for healthier children

In 2014, Nutrition International helped establish a strong Infant and Young Child Nutrition (IYCN) program for the prevention and treatment of child undernutrition.

This program emphasized the continuum-of-care approach to improve timely initiation, quality and quantities of complementary foods for children 6-23 months. It also supported the training and supervision of community health workers, to ensure they were better equipped to counsel and support infant and young child feeding (IYCF) practices and monitor the community-based management of acute malnutrition to prevent relapse. Counseling mothers and other caregivers on IYCF was also part of this program.

Using multiple micronutrient powders to improve nutrition for children

Nutrition International has actively worked with the government to use multiple micronutrient powders (MMNPs) to improve the quality of complementary foods and prevent childhood anemia in their efforts to increase the nutritional status of their youngest population. In the government’s Public Nutrition Policy and Strategy 2015-2020, developed with Nutrition International support, MMNPs are recommended as part of complementary foods for infants.

We evaluated the feasibility and effectiveness of implementing programs with multiple micronutrient powders for Afghani children aged 6 to 23 months with positive results. We found this intervention to be effective in reducing anaemia and it was well accepted by mothers, caregivers and health workers.

Some of the highlights from our work included:

  • improve the nutritional status of very young children (between the ages of 6 to 24 months), approximately 6.25 million sachets of multiple micronutrient powders were distributed to approximately 50,000 children, in two provinces.
  • in 2010, with support from FAO, Nutrition International helped to distribute approximately 1.2 million MMNP sachets to 8,100 children – 120 sachets per child – in four districts of Afghanistan.
  • provide MMNPs to children in 13 districts of the Wardak and Laghman provinces, supporting the distribution of MMNPs through complementary feeding efforts, under our Infant and Young Child Nutrition Project.
Reducing impact of anaemia for pregnant women

In order to reduce and prevent anaemia among pregnant women, and help protect against neural tube defects in newborns, Nutrition International implemented an iron and folic acid (IFA) supplementation program across 15 provinces.

In 2013 and again in 2014, we helped 280,000 pregnant women receive iron and folic acid (IFA). These efforts included support to:

  • train nearly 10,000 health facility staff on the IFA program.
  • strengthen supply chain management.
  • develop behavior change communication materials to increase awareness in the community.
  • encourage counseling sessions with pregnant women.

Nutrition International’s advocacy with the BPHS and the Ministry of Public Health led to the adoption of WHO guidelines, which included specifications on product, packaging, improved data management and integration of IFA within the antenatal care health package.

Reducing risks of iodine deficiency disorders

To reduce iodine deficiency disorders through our salt iodization program, Nutrition International worked from the ground up in Afghanistan.

Working alongside key partners, this included assessing Afghanistan’s salt mines and lakes; training salt millers and nutrition officers on the importance of adequately iodized salt; supporting the revolving fund for program sustainability; ensuring quality assurance; and supporting the establishment of a Management Information System at the Ministry of Health.

This program helped in the efforts to prevent iodine deficiency in newborns, young children and pregnant women, as well as in the general population.

In 2009, an emergency nutrition program was launched by Nutrition International in response to the needs of women and children who were affected by political instability and insurgency. This was an integrated program implemented across 22 districts in 11 priority provinces. As part of these efforts, we helped ensure those in need had access to life-saving nutrition interventions:

  • 230,000 children below the age of 5 received multiple micronutrient powder (MMNPs) sachets as a component of appropriate infant and young child feeding.
  • 70,000 children received zinc and ORS to treat diarrhoea.
  • 125,000 pregnant women received iron and folic acid (IFA) tablets to reduce anemia and related complications and protect against neural tube defects in newborns.