Assistance for Families and Indigent Afghans to Thrive (AFIAT)

A Whole System Approach to Providing Quality Care

A strong health workforce is the foundation to providing equitable and sustainable care. The AFIAT project empowers health workers across all levels of Afghanistan’s health system to improve services and save lives.

Community health workers (CHWs) play an integral role in improving patient-provider connections. While offering home visits, counseling, and educational services, CHWs also refer patients to local health facilities when additional care is needed. 

Raihana, a CHW in Bamyan Province, participated in AFIAT-led training sessions on nutrition and community health education. Thanks to what she learned, Raihana was able to identify that a patient’s baby was malnourished, refer them to a health facility, and provide counseling.

Many expectant mothers rely on midwives to provide antenatal and postnatal care. Recognizing their important role in the primary health care system, AFIAT developed a tailored training program that addresses the unique challenges midwives face in the facilities where they work.

This adapted, evidence-based mentorship style has helped 800 midwives expand their skills and provide quality care to pregnant women and their newborns.

Maintaining a consistent, data-driven medicine supply chain is essential to ensuring Afghans have access to the treatment they need. But without proper training and knowledge, pharmacists cannot adequately track stock levels and ensure patient needs are met.

To equip pharmacists with the skills they need, AFIAT provided training on how to estimate and track medicine supply. As a result, pharmacists’ knowledge levels surged from 25% in 2021 to 68% by 2023 in health care facilities across all 14 AFIAT-supported provinces.

Tuberculosis remains a major threat, especially among women. Confirming a diagnosis is the first step toward treating and preventing the spread of this deadly disease. However, many lab technicians must rely on insufficient diagnostic tools that may give sick patients false-negative results.

In Takhar Province, AFIAT stepped in to address this longstanding problem by installing a GeneXpert machine. With a precision rate of 99.5%, lab technicians can now use this state-of-the-art equipment to achieve an accurate diagnosis and get patients the care they need.


Assistance for Families and Indigent Afghans to Thrive (AFIAT) strives to improve the quality of primary and secondary health and nutrition services in targeted rural areas; increase access to high-impact and evidence-based health and nutrition services; enhance adoption of optimal health and nutrition behaviors by communities and households; coordinate and standardize medical supply management across all stakeholders; optimize registration and import procedures for medical commodities; and collaborate with partners to plan, finance, and manage resilient health services. 

By applying proven methods and innovations, our approach will result in sustainable improvements in maternal and child health, family planning and reproductive health, TB, and nutrition, particularly for women and preschool children, youth, men, and rural Afghans. To sustain these outcomes, we will work with partners to increase public and private investments in health and increase transparency and accountability.

Putting Systems Thinking into Practice in Afghanistan

While Afghanistan’s health system has seen steady improvements over the last two decades, a complex set of interconnected challenges presents persistent barriers that impede the delivery of universal health care services, especially in remote or otherwise underserved areas. To navigate these challenges, a systems thinking approach is crucial.