1. Health Literacy in Afghanistan Achievements and Way forward Regional Ministerial Meeting for Asia and the Pacific on Promoting Health Literacy 29 and 30 th April 2009, Beijing, China Islamic Republic of Afghanistan Ministry of Public Health Nadera Hayat Burhani, MD Deputy Minister for Health Care Service Provision

2. Contents Afghanistans Demographic Situation Briefing on Health Situation Achievements for health literacy Challenges and barriers Recommendations for capacity building

3. Located in South Asia Land locked country Mosaic ethnic groups Diverse geography Afghanistan

4. Demographic Situation Population: 24 million [Central Statistic Office, 2007] Female / Male Ratio : 49/51 Literacy Rate : 35-40 % [Ministry of Education 2007) GDP : 415 USD [ central Statistic Office, 2007 ] Average Life Expectancy is 46 years Human Development Index: 0.312

5. Present Health Situation Under five mortality rate: 191 / 1000 live births Maternal Mortality Ratio : 1600/100000 live births Coverage to Primary Health Services: 85 %

6. Present Health Situation Afghanistan National Development Strategy and Health and Nutrition Sector Strategy 2008-2013 Two main strategies for health care provision : Basic Package of Health Services and Essential Package of Hospital Services, contracted out Public Private Partnership for Health strategy developed

7. Progress in Percentage of Health Facilities with at least one female health worker, Afghanistan 2003, 2008

8. Progress in Child Mortality Rate in Afghanistan

10. Progress in Percentage of Heath Facilities with at least one Female Health Workers, Afghanistan 2003-2008

11. Presence of more than 20000 Community Health Workers Improving health facility – community interaction by Partnership Development Quality ( PDQ ) and Participatory Learning Approach ( PLA) strategies Establishing Healthy School Initiative since 2006 Support to Communities Communication and vaccination Campaigns Achievements in Health Literacy

12. Planned, Systematic Health Education Sessions Providing good working environment for health workers to provide better information for patients Increased number of female health workers Support to Health Facilities Building Capacity of health workers Achievements in Health Literacy Increased the number of outpatient visits as a consequence of improvement in the health literacy

13. Progress in institutional Delivery, ANC and FP Utilization

14. Low Socio-economic Condition ( Education, income and employment ) Gender: women suffer more due to low literacy rate Insecurity in some parts of the country Challenges in Health Literacy Low access to available information Cultural barriers and believes

15. Recommendations : How to build the capacity A rapid assessment to understand the real challenge of the health literacy issues in Afghanistan Advocacy for Inter-ministerial collaboration specially with ministry of education and religious affairs A national policy should be developed,

16. Promoting and strengthening Telemedicine approach Strengthening pictorial language Strengthen interpersonal Communication skills of Health workers Capacity building for Media and building partnership with them Establishing an electronic system of health information provision Recommendations : How to build the capacity

17. Establishment of technical advisory group or medical expert association on health literacy. Exchange of experts and experience through affiliation programs among the Regional countries. Having joint Regional Protocols and plans for health literacy Setting of standards for health literacy at all levels. Establishment of a data sharing network Set up an E-health or telemedicine network Recommendation: How to build the capacity at regional level

18. Questions, Comments