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Kabul Declaration for Maternal & Child Health
Renewing Commitment to Reducing Preventable Deaths among Women and Children
Building upon the commitments of reducing preventable maternal and child deaths, the
Government of the Islamic Republic of Afghanistan joined “A Promise Renewed” movement
in 2013 and developed acceleration plans in the same year for achieving the Millennium
Development Goals 4 and 5 as part of “Saving the Lives of Mothers and Children” initiative.
To leverage newly available evidence, improve accountability and accelerate improvements
in coverage of high impact interventions, the Government of the Islamic Republic of
Afghanistan is now recommitting its resources and support to make the health of women and
children its highest priority. This renewed commitment is made at the “Call to Action: Renewing
the Promise for Maternal and Child Survival” event in Kabul, Afghanistan on 12 May 2015.
This “Kabul Declaration” will also help Afghanistan in achieving the future sustainable
development goals for health, in alignment with the updated Secretary General’s “Global
Strategy for Women, Children and Adolescents” which provides a roadmap for ending
preventable maternal and child deaths by 2030.
CALL TO ACTION AFGHANISTAN
Afghanistan is a signatory to the Millennium Declaration and has a number of policies and
strategies to improve the health and nutrition of mothers, children and the newborns.
This historic Call to Action: Renewing the Promise for Maternal and Child Survival in Kabul
brings together policy makers, implementers, partners and other stakeholders to reaffirm high
level commitment to achieving the country’s targets for 2020 and ensure progress beyond.
The Call to Action has made it evident that improvements in the coverage and quality of
essential health interventions in Afghanistan will save the lives of thousands of mothers and
children per year, who are currently dying of preventable causes. It has further underscored
the special attention needed to achieve equity for improved health outcomes for all including
disadvantaged, vulnerable populations and internally displaced people.
Participants in the Call to Action Afghanistan unanimously agree and commit to achieving
the following targets by 2020:
Reduce the Maternal Mortality Ratio to 250 deaths per 100,000 live births
Reduce the Neonatal Mortality Rate to 25 deaths per 1,000 live births
Reduce the Child Mortality Rate to 65 deaths per 1,000 live births
Reduce the Stunting Rate in under-five children to 30%
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PRINCIPLES
We, the undersigned, renew our promise for maternal, newborn and child survival and
commit to reducing preventable deaths by:
1. Improving access to quality health services in the framework of Basic Package of Health
Services (BPHS) and the Essential Package of Hospital Services (EPHS). Gains in access to
health services will be built upon to provide healthcare, including specialized care, to all. The
country with support from partners will work towards provision of universal health coverage to
ensure equitable delivery of essential, life-saving maternal and child health interventions including
family planning. The leadership in the Ministry of Public Health, along with partners will accord the
highest priority to the provision of rights-based care for women, children, adolescents and youth in
Afghanistan in order to accelerate progress for better health outcomes.
2. Strengthening health systems through strong leadership and governance. Through
leadership and governance, effective measures will be undertaken to address corruption in the
health sector and ensure the health sector responds to the needs of the public especially women
and children. This and other efforts will prioritize improvements in the health system’s human
resources, financing, information systems, innovation and research, delivery of services, supplies,
technologies. These actions require donors and partners to harmonise their technical and financial
support in line with the aid effectiveness principles of the Paris Declaration and the Accra Agenda
for Action.
3. Equipping individuals with information and knowledge for informed decisions on health
matters. Engaging with communities for health promotion will ensure healthy behaviours by
individuals and families and equip them with information on when and where to seek care. This
includes efforts to prevent child marriage and early pregnancies. New partnerships will be explored
with the private sector, in particular for innovations in generating demand and enhancing utilization
of services.
4. Producing tangible results. Existing strategies will be refined, and new ones developed where
necessary to ensure reproductive, maternal, neonatal, child and adolescent and youth health
programmes are achieving results. For adolescent health, it will be important to increase coverage
of culturally sensitive interventions with focus on regions with high child-bearing among
adolescents. Results based on measurable indicators and time-bound targets will incorporate
attention to quality for all health programmes including respectful maternal health care.
5. Collaborating within and across sectors through government-led, nationally driven plans to
address the social determinants of health and enhance equity and dignity. This means working
more closely with other ministries and through collaboration with civil society organisations and the
private sector to improve education, nutrition, sanitation and hygiene outcomes. Engagement with
communities will help include voices of people especially women in decision-making related to their
health and the health of their families.
6. Promoting transparency and accountability. In addition to existing mechanisms, scorecards
introduced as part of the Call to Action that monitor performance on a range of reproductive,
maternal, neonatal, child and adolescent health and nutrition indicators will be henceforth made
publicly available and reviewed by health authorities four times a year.
7. Strengthen health financing leading to increased national and international allocation of
resources to Afghanistan’s health sector. Advocate and increase healthcare financing with an
aim to reduce out-of-pocket spending. This will include measures for financial risk protection,
innovative schemes on health financing and improved resource tracking.
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COMMITMENTS
In line with the above principles, we the Ministry of Public Health with support of
partners commit ourselves to act on the following priorities:

Reduce unmet need for family planning by 10% by 2020 (with focus on enabling environment,
availability of rights-based quality family planning services and commodities through a multisectoral strategy, skilled providers, community-based approaches and male involvement and
demand generation)

Increase quality skilled birth attendance to at least 60% and enhance access to reproductive
health services by 2020 (with special focus on active management of third stage of labour,
management of pre-eclampsia with magnesium sulphate, antibiotics for premature rupture of
membrane and other essential maternal health interventions)

Increase essential and emergency care of sick newborns to at least 50% by 2020 (with special
focus on case management of severe neonatal infection, kangaroo mother care, neonatal
resuscitation, full supportive care for prematurity, use of chlorhexidine and postnatal care)

Increase national vaccination coverage to at least 90% for BCG, Polio, Pentavalent 3,
Pneumococcal, Rotavirus and Measles vaccines with no district having a coverage for
Pentavalent 3 less than 80% by 2020 (with special focus on achieving polio eradication and
elimination of measles and maternal and neonatal tetanus)

Increase coverage of interventions for prevention and management of pneumonia and
diarrhoea to at least 60% by 2020 (with special focus on management of diarrhoea with oral
rehydration solution and zinc, case management of pneumonia, promotion of handwashing, ending
open defaecation and provision of safe drinking water)

Increase treatment of acute malnutrition to at least 50% and equip at least 50% of health
workers with skills in nutrition counselling including promotion of infant and young child
feeding practices by 2020 (with special focus on promotion of breastfeeding, appropriate
complementary feeding, iron folic acid supplementation for adolescent girls and pregnant women,
and other essential nutrition interventions)

Ensure accountability through quarterly review on performance of reproductive, maternal,
newborn and child health using Call to Action Scorecards, led by the Ministry of Public Health.
THE PLEDGE: Through national action and international cooperation, we pledge to
accelerate progress on maternal, newborn and child survival. We hold ourselves
accountable for our collective progress towards this goal. And on behalf of all women and
children in Afghanistan, we recommit our efforts towards ending preventable deaths among
women and children.
12 May 2015, Kabul.
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