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HEALTH
Figure 9.1: In-patients A and out-patients B in the year before the survey, by sex, and by age as percentage of the total population in the same age-sex group.
A. In-patients
5 10
15 20
25 30
0-9 10-19
20-29 30-39
40-49 50-59
60-69 70-79
80+ Tota l
Ma le Fema le
Tota l
B. Out-patients
5 10
15 20
25 30
0-9 10-19
20-29 30-39
40-49 50-59
60-69 70-79
80+ Tota l
Ma le Fema le
Tota l
With 2.7 million, the volume of out-patients is considerably larger than that of in-patients Table 9.4, panel B. In terms
of the age-sex distribution, the most notable is the over-representation of children under ten and again women in the reproductive age group. This is made visible in
Figure 9.1, panel B, where it can be seen that around 11 percent of children under 10 had sought ambulant medical care. Only 5 percent of persons in the age group 10-19 did so, a level
that is maintained for men up to the age group 40-49, whereas for women the share that received out-patient care is rising rapidly from age 20 onwards. Overall, 10 percent of the population received ambulant care, 12 percent among
women and girls, and 8 percent among men and boys.
89
HEALTH
9.2.4 Use of health care providers
There are signiicant differences in the use of health services between in-patient and out-patient care, as well as between urban and rural populations. For hospitalisation public health facilities are the most important care providers, with 19
percent for national hospitals and 58 percent for provincial and other public health facilities in-patient care Table 9.5.
Private clinics and private doctors and NGOs serve 17 percent of the population for in-patient care, and 5 percent is treated abroad.
For ambulant health services, the irst category is private and NGO care, which provides more than half of the services. In urban areas this is even 69 percent, but also in rural areas it is close to half of out-patient service delivery – almost
as important as public health care. All together, the private sector served around 1.5 million people for ambulant care.
Table 9.5: Health care seekers in the year before the survey, by residence, and by health care provider A. In thousands B. In percentages
Health care provider Urban
Rural Kuchi
National Urban
Rural Kuchi
National
a. In-patient health care provider
National hospital 101.7
72.6 4.8
179.1 43.1
11.2 12.5
19.4 Other public health facility
65.2 446.3
26.2 537.6
27.6 68.7
68.3 58.2
Private health facility 54.4
99.7 4.5
158.5 23.0
15.3 11.7
17.2 Health facility abroad
14.9 31.0
2.9 48.8
6.3 4.8
7.6 5.3
Total 236.2
649.5 38.4
924.0 100.0
100.0 100.0
100.0
b. Out-patient health care provider
National hospital 90.5
41.3 1.9
133.7 14.0
2.1 1.4
4.9 Other public health facility
102.4 941.4
64.9 1,108.7
15.8 48.6
47.7 40.7
Private health facility 448.9
942.6 68.8
1,460.3 69.2
48.7 50.5
53.7 Health facility abroad
6.7 10.9
0.6 18.2
1.0 0.6
0.4 0.7
Total 648.6
1,936.2 136.2
2,721.0 100.0
100.0 100.0
100.0
9.3 Child health
Based on the principle of rotating modules, the NRVA 2011-12 round had a restricted battery of questions on child health compared to the 2007-08 round. Only information about Vitamin A supplementation, fever and diarrhea, and acute
respiratory illness ARI for children under ive was collected. Reduction of vitamin A deiciency, diarrhea and pneumonia are critical to the achievement of MDG 4, the reduction in under-ive mortality. In addition to this child health information,
the number of under-ives with a birth certiicate was recorded.
9.3.1 Birth registration
Although strictly not a health indicator, the percentage of children with a birth certiicate may have health implications in the sense of admission dificulty to health facilities, as well as access to various other services and human rights. The
International Convention on the Rights of the Child – to which Afghanistan is a party – states that every child has the right to a name and a nationality, and the right to protection from being deprived of his or her identity. Birth registration is
a fundamental means of securing these.
NRVA 2011-12 indicated that 35 percent of children under 5 had a birth certiicate
1
Table 9.6, slightly below the share reported by the MICS 2010 37 percent. This would imply that 3 million under-ives are not registered as citizen of
Afghanistan. Urban children were more than twice as likely to be registered as rural children 64 compared to 29 percent, and only 16 percent of Kuchi children were registered.
1 Based on verbal report, without having seen the certiicate.
