Health Emergency, World Health Organization, Kabul, Afghanistan.
Public Health Department, Faculty of Medicine, Cairo University, Giza, Egypt.
Front Public Health. 2023 Sep 21;11:1209986. doi: 10.3389/fpubh.2023.1209986. eCollection 2023.
Afghanistan has been in an active state of conflict and war for twenty continuous years. Social services like health and education have been badly affected, facing issues such as service disruption, brain drain, and generalized instability. Health indices that provide proxy indicators for general population wellness, such as maternal health, child mortality, and immunization coverage, show that the health services available to the Afghan population are sub-optimal. Investment in social service and interventions has increased. The World Bank and the United Nations through its agencies (The World Health Organization (WHO) and United Nations' Children's Fund (UNICEF) are providing social support through targeted and strategic programs. However, the topographic and environmental realities of Afghanistan, with its broad mountain coverage, propensity toward natural disasters, and latent conflict, has made data and information gathering arduous. Since data is essential for measurement and management, the WHO Health Emergencies (WHE) information management unit at WHO Afghanistan has delivered an innovative form of data analysis, specialized and targeted at providing improved information on communities that are not adequately covered by health services. Deploying a geographical information system (GIS) approach, the WHE team has collated primary and secondary data from a combination of datasets to produce a far-reaching piece of analysis. The analysis of underserved communities in hard to reach, remote locations, provides a live, evidence-based information product. This provides a working tool that is essential to primary health programming and intervention in Afghanistan. The estimates show that approximately 9.5 million individuals in 22,181 villages across 34 provinces are underserved by primary health services. This paper is presented to explain the underpinning methodology.
阿富汗已连续 20 年处于冲突和战争的活跃状态。医疗和教育等社会服务受到严重影响，面临服务中断、人才流失和普遍不稳定等问题。孕产妇健康、儿童死亡率和免疫接种覆盖率等反映一般人群健康状况的健康指标表明，阿富汗人民获得的卫生服务不尽如人意。对社会服务和干预措施的投资有所增加。世界银行和联合国通过其机构（世界卫生组织 (WHO) 和联合国儿童基金会 (UNICEF)）正在通过有针对性和战略性的方案提供社会支持。然而，阿富汗广阔的山地覆盖、自然灾害频发和潜在冲突的地形和环境现实，使得数据和信息收集变得困难。由于数据是衡量和管理的基础，因此世卫组织阿富汗卫生应急（WHE）信息管理股采用了一种创新的数据分析形式，专门针对服务不足的社区提供更好的信息。该 WHE 团队采用地理信息系统 (GIS) 方法，结合来自多个数据集的主要和次要数据，进行了一次广泛的分析。对偏远和难以到达的服务不足社区的分析提供了一个基于证据的实时信息产品。这为阿富汗初级卫生规划和干预提供了一个必要的实用工具。该分析表明，在 34 个省的 22181 个村庄中，约有 950 万人得不到初级卫生服务。本文旨在解释其基本方法。
