Save the Children has worked to improve the lives of Afghan children and their families for more than 20 years — initially in Afghan refugee sites in Pakistan and, since 1995, in Afghanistan. With difficult challenges facing the people, especially children and women, Save the Children seeks to improve their quality of life through programs in health, education and child protection.

Challenges for Children

In the past five years progress has been made, but Afghanistan still faces many challenges. It has high infant, child and maternal mortality; low immunization; chronic nutritional deficiencies among children; low literacy levels; low school enrollment and high drop-out rates, especially among girls; and difficulty protecting children and promoting their rights.

Numbers at a Glance

• One Afghan child in five dies, often of a preventable cause before her or his fifth birthday
• 85% of women give birth at home with untrained attendants
• 30% of healthcare facilities are without female health professionals: doctors, nurses and midwives
• 100,000 teachers are needed in Afghanistan, including some 48,000 new women teachers, if there is to be an essential increase in girls' enrollment and retention in school
• Only one female teacher in three has the required education; some 27,000 current teachers will need support to increase their knowledge and teaching skills
• The vast majority of rural parents do not understand child development. According to a recent Save the Children survey, only 19% of mothers believe play is useful to promote learning and only 4% believe that it readies a child for school; no fathers understood that play helped their children's cognitive development.

Our Response

Health: The health care system in Afghanistan was largely destroyed by decades of conflict — particularly services for women and children. As part of the Ministry of Public Health's national effort to address high maternal and infant mortality rates, Save the Children supports maternal-child health initiatives, including community midwife education and newborn health programs and a basic package of health services. These programs provide important services to pregnant women and new mothers as well as newborns and young children. A project to improve adolescent girls' access to information about their health is also positively affecting attitudes, particularly fathers' towards girls' use of health services — a significant development for Afghan girls and women. Save the Children's highly successful nutrition rehabilitation pilot initiatives for children younger than three are poised to make significant impact nationwide (see story included at the end of this profile, Reaching out to Mothers and Children in Faryab).

Education: Save the Children works to increase children's participation in basic education that promotes their development and helps prepare them for responsible roles in society. We support the Ministry of Education's efforts to improve and expand in-service teacher training and school leadership and management training. We also support children's education through innovative home-based early childhood development activities and parenting education. Transition-to-school programs, health and nutrition education as well as community library and Reading Buddy programs for in-school and out-of-school children are hallmarks of Save the Children's educational outreach in Afghanistan today.

Child Protection: Afghanistan remains a generally unsafe place for children — especially street and working children, children who have been institutionalized because of family constraints and children injured by landmines or other accidents. There are also many girls and boys who are subjected to corporal and psychological punishment in schools and homes. Save the Children addresses these problem through community- and school-based education for teachers, parents and grandparents and other community members. With our International Save the Children Alliance partners, other child-focused organizations and the Ministry of Labor and Social Affairs, we work to ensure that the Child Protection Action Network we helped create remains strong. Save the Children-led Child-to-Child group activities also are key to children receiving help with their day-to-day problems.

Looking Forward for Children

Despite ongoing challenges, Save the Children is committed to supporting and sustaining development efforts for Afghan children and families, especially mothers, by continuing to:

• Deliver integrated, community-based education and protection programs, especially for girls and preschool children.
• Partner with communities and local public health professionals to improve young children's nutritional status and offer opportunities for their mental, emotional and physical development.
• Support the Ministry of Education to further strengthen and improve school leadership, management, environments and instruction for child-centered teaching and children's learning.
• Support the Ministry of Public Health's ability to innovate, expand and deliver services, including those addressing the emerging challenge of HIV/AIDS.

Reaching out to Mothers and Children in Faryab

Malnutrition in Afghanistan is widespread. Save the Children's research in Jawzjan Province found high levels of malnutrition — especially among children under five. Based on our experience elsewhere in Asia, our health team in Afghanistan is bringing the benefits of our proven and sustainable nutrition rehabilitation program to children in remote, northern reaches of the country. 

Our "Positive Deviance/Hearth" approach identifies behaviors practiced by families whose children are well-nourished, and then uses this information to teach others about these positive behaviors. The "hearth," or home, is the location for the child-focused nutrition education and rehabilitation sessions. By teaching and working in collaboration with community health workers and local health clinic staff, we improve children's nutrition while building an important foundation of knowledge and skills for their caregivers.

Save the Children initiated a successful PD/Hearth pilot in Jawzjan Province in 2006. In just 18 months, the initiative has been replicated in villages there and in Faryab Province. The most recent village to benefit from the initiative has been Toghlamast village in remote, southern Faryab, where overall mild to severe malnutrition was 69 percent.  Early results suggest that Toghlamast’s youngest children will do as well as their peers in other nearby villages — and be well on their way to better health and wellbeing soon.