Since 2002 three main donors of health sector, namely, The  European  Union  (EU),  the  United  States  Agency  for  International Development  (USAID)  and  the World  Bank (WB) have played a pivotal role in financing health services and health system development in Afghanistan. Significant improvements have been made in the health sector of Afghanistan. Improvements are seen in the access to key maternal health services such as antenatal care (32% in 2006 to 54% in 2012) and institutional deliveries (15% in 2006 to 40% in 2012). Despite these major accomplishments, many challenges remain. For instance, full immunization coverage of children has not increased in the past half-decade regardless of the investments made in the Expanded Program on Immunization (EPI).

SEHAT is jointly financed by the World Bank, EU and the USAID. It is financing the implementation of the BPHS and EPHS through contracting out and contracting in arrangements both in rural and urban areas in provinces the project is also strengthening the national health system and MOPH’s capacity at central and provincial levels, so it can effectively perform its stewardship functions in the sector.

The government of the Islamic Republic of Afghanistan with the help of international assistance has made great progress in improving primary health care. From an epidemiological and cost effectiveness perspective, this is as it should be. The first priority of any national health system should be to make the greatest impact on reducing morbidity and mortality. There reaches a point however, where greater attention needs to be placed on the hospital sector. For serious illnesses and injuries, survival is only being possible through medical and surgical interventions in hospitals.