24 MSF IN AFGHANISTAN ANNUAL OVERVIEW OF ACTIVITIES - 2023
KHO S T
START OF ACTIVITIES KEY FIGURES
2012
19,098 deliveries assisted of which 3,741 had direct
Paktia
obstetric complications
790 caesarean sections
2,124 neonatal admissions
Khost
Paktika
Pakistan
MSF has been MSF staff at Khost Maternity
Hospital assist an average of
working in Khost 1,600 deliveries each month.
Province since 2012,
The hospital serves as a referral
focusing on providing centre for Direct Obstetric
Comprehensive Complications (DoCs) and
normal deliveries for the
Emergency Obstetric province.
and Neonatal Care
Afghanistan has one of the
(CEONC) at the Khost highest maternal mortality
Maternity Hospital. rates in the world. Obstetric
complications before, during and
after birth are the biggest causes
of maternal mortality and Khost
Maternity Hospital (KMH) was
established to help mothers with
such complications and those
with risky pregnancies to deliver
safely.
KMH has nine delivery beds,
three 20-bed inpatient wards, a
four-bed maternal intensive care
unit (ICU), a 32-bed neonatal
intensive care unit (NICU) and
eight beds for Kangaroo Mother
Care (KMC).
In Khost, MSF observes a
set of admission criteria for
expectant mothers to ensure
that the mothers with at-risk
pregnancies and direct obstetric
ANNUAL OVERVIEW OF ACTIVITIES - 2023 MSF IN AFGHANISTAN 9
marking an average of 590
each month. Since MSF
started activities in the NICU,
The primary diagnoses in
the neonatology and NICU
the number of children being
admitted to the paediatric
departments included sepsis ER and neonatal units of the
the average bed occupancy (1,117 cases, 78%), low birth hospital remains significantly
rate (BOR) was 149%. MSF weight and/or prematurity (163 high, putting a strain on
implemented measures to cases, 11%), and perinatal the hospital’s resources
address this, such as increasing asphyxia (158 cases, 11%). and contributing to high
human resources, expanding bed occupancy rates in the
bed capacity, and enforcing Mazar-i-Sharif Regional
neonatology unit.
stricter adherence to admission Hospital is receiving a high
and discharge criteria but the number of patients who prefer
BOR remained significantly high to seek care directly at the
even at the end of the year.
hospital, bypassing primary and
secondary healthcare facilities.
The average mortality rate
in neonatology was 15%, and Despite the implementation
the average length of stay in of a triage system to prioritize
the neonatology and NICU moderate to severe cases,
departments was 5.3 days.
complications get priority
care, while also taking care of
other normal deliveries. Some
©Oriane Zerah/MSF
mothers in stable condition
are referred to health facilities
nearest to them or to Khost
Provincial Hospital, to retain
capacity to admit complicated
cases.
However, due to limitations
in the healthcare system in
Khost, MSF had to expand its
admission criteria to admit
other mothers. As a result, the
hospital has been receiving high
numbers of mothers, adding a
strain to the resources in the
hospital. Out of 37,047 maternal
deliveries in public medical
institutions in Khost Province in
2023, more than half (52%) took
place at MSF’s Khost Maternity
Hospital.
There were limited referrals
by MSF of patients who don’t
meet the admission criteria
for KMH to external facilities
due to uncertainty regarding
the availability of services at An MSF nurse examines a seven-month-old baby suffering from pneumonia at the Paediatric Emergency Room of Mazar-i-Sharif
healthcare facilities nearest to Regional Hospital.
patients.
10 MSF IN AFGHANISTAN ANNUAL OVERVIEW OF ACTIVITIES - 2023 ANNUAL OVERVIEW OF ACTIVITIES - 2023 MSF IN AFGHANISTAN 23

BAMYA N
START OF ACTIVITIES KEY FIGURES
December 2022
Samangan
25,605 outpatient consultations
Sari pul Baghlan 4,186 gynaecological consultations
Bamyan Parwan
1,799 antenatal and postnatal consultations (ANC & PNC)
Ghor
924 family planning consultations
Wardak

Daykondi
160 deliveries assisted
Ghazni

In Bamyan, MSF Launched in December 2022,
MSF’s community healthcare
runs a community programme in Bamyan Province
healthcare program aims to provide services to
centering on mother underserved communities in
©Lynzy Billing/MSF
MSF thus started by delivering
mother and child healthcare
services, including obstetric and
gynaecological consultations,
antenatal and postnatal care, An MSF nurse checks the blood pressure of a two-year-old patient at the MSF drug-resistant tuberculosis (DR-TB) hospital in

and child healthcare Saighan, Shebar and Yakawlang family planning, normal Kandahar.
01 districts. deliveries, and outpatient services
services. for children under five years.
MSF also supports other Figure 14: Inpatient Therapeutic Feeding Centre Admissions -
Kandahar (2022-2023)
These communities, located facilities including the Kandahar
more than 10 kilometres from In 2023, as the year progressed, Provincial Tuberculosis Centre 300
the nearest healthcare facilities, due to the needs for general (PTC), Sarpoza Prison, Mirwais 250
faced significant challenges outpatient care and requests by Regional Hospital (MRH),
200
in accessing medical care, the communities and the health and Zabul PTC, providing TB
150
particularly for pregnant women, authorities, MSF expanded its screening and consultations.
100
young children, the elderly and services by building extensions The hospital in Kandahar is
50
women in general. on the healthcare structures to also the only referral centre for
0
patients with drug-resistant TB Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
from Kandahar and provinces in
©Nava Jamshidi/MSF

the southern region. 2022 2023

MALNUTRITION Source: MSF District Health Information Software 2 (DHIS2)

PROGRAMME Out of 19,641 patients screened, into the ATFC, representing a

Due to the needs in the province,
MSF started a nutrition
component in the project in
April 2022 and currently runs
a 40-bed inpatient therapeutic
feeding centre (ITFC) and an
ambulatory therapeutic feeding
centre (ATFC) for children under
five years.
An MSF midwife, seeing a patient at Band-e-Amir community health facility in
Yakawlang 01, a district in Bamyan Province.
1,669 children with severe acute 30.9% increase compared to the
malnutrition were admitted into previous year.
the ITFC in Kandahar, more
Most of the patients admitted to
than double that admitted the
the ITFC and ATFC came from
previous year (660). More than
Dand, Arghandab, Zheray, and
60% of the ITFC admissions
Panjwaiee districts in Kandahar.
during the year were between
June and September. A total of
5,666 children were admitted