Supporting National Efforts to Eradicate Polio and Strengthen Routine Immunization

Our first collaboration with the Afghanistan Ministry of Public Health (MOPH) started in 2015 with a focus on supporting polio eradication and strengthening routine immunization (RI) in a country that is still polio endemic. Through a project designed to create demand for immunization, we implemented appropriate interventions to increase demand for immunization whereby the local community from influencers to teachers and volunteers engaged in the project’s activities to improve knowledge, attitude, and practices regarding immunization to, eventually, contribute to improving immunization coverage.

GHD|EMPHNET and the MOPH also worked to strengthen the skills of the team running the Management Information System of the Expanded Program on Immunization (EPIMIS) to ensure best use of EPI data for action. This collaboration came in response to the need for skilled personnel in this data collection and analysis at the provincial and regional levels.

The MOPH and GHD|EMPHNET are also collaborating to address the need for enhanced performance of the EPI team by investing in supportive supervision and monitoring within provincial EPI teams, supporting training of EPI supervisors from the 34 provinces of Afghanistan in planning, conducting, and reporting supportive supervision visits.  

In 2019 and with support from GHD|EMPHNET, the Ministry established a CRS surveillance system that obtains standardized data on CRS incidence and creates a basis for documentation and verification of rubella virus elimination, detection, and isolation of CRS-affected infants. Availability of such a system ensures early provision of appropriate care of the disease, and hence rapid mitigation of it.

To explore means of strengthening public-private sector engagement to improve coverage in hard-to-reach populations, GHD|EMPHNET supported the Ministry in conducting a rapid assessment of the Partnership with the Private-for-Profit Health Service Providers which served as a basis for recommendations where to increase engagement to improve routine immunization coverage in low performing provinces in Afghanistan.

In 2020, GHD|EMPHNET in collaboration with Aga Khan University conducted a serosurvey to estimate population immunity to polio virus in two provinces of Afghanistan. This survey was a follow up of a previous one which targeted 14 provinces and was which limited to sample collection at health facility level. In the most recent study, a community-based seroprevalence survey in Kandahar and Nangarhar cities was included.

Supporting Biological Threat Reduction

In one of the earliest collaborations between GHD|EMPHNET and the MOPH, health professionals from human health and veterinary laboratories, in the capital and major provinces, have been trained in biosecurity and biosafety best practices. In a more recent project, GHD|EMPHNET started to build laboratory capacity in the handling of biological samples and safe storage and disposal of reagents- both of which are key in the practices and procedures pertinent to laboratory network and management in Afghanistan.

Strengthening Antimicrobial Surveillance

In October 2019, GHD|EMPHNET in collaboration with the Tides Center, Ending Pandemic and the MOPH started implementing the Partnership for Antimicrobial Resistance (AMR) Surveillance Excellence “PARSE” project. GHD|EMPHNET collaborated with the members of the South Asia Technical working group that include networks and partners from Afghanistan, Bhutan, Nepal, and Pakistan. Through this partnership, common protocols, and SOPs for AMR surveillance will be developed. So far, GHD|EMPHNET completed assessment and gap analysis for Afghanistan to inform the development of AMR surveillance protocols and SOPs in line with the of the World Health Organization’s standard protocol for integrated multisectoral surveillance known as the “Tricycle Program.”

 Building Field Epidemiology Capacities

GHD|EMPHNET’s work in Afghanistan grew when the organization supported the establishment of the Afghanistan Field Epidemiology Training Program (FETP) in early 2019. This is FETP is an intermediate, one-year program hosted and run by the Afghanistan National Public Health Institute, with several departments within the MOPH providing joint oversight to the program implementation. The first cohort of the program was successfully completed, and the second cohort was officially started in August 2020. Building on this achievement, GHD|EMPHNET and the MOPH mobilized FETPs during 2020 to scale up alert and response activities to many outbreaks including polio and COVID-19.

Continuing a Strong Partnership

In late 2018, GHD|EMPHNET and the MOPH signed an MOU under which both parties agreed to utilize collective efforts and exchange of resources with the purpose of improving public health status in Afghanistan. Under this MOU, both parties will work toward enhancing the management of common public health problems and threats for eventual improvement of population health outcomes in the country.