Integrated Health, Nutrition and WASH Services Saving Lives in Afghanistan

Afghanistan faces a complex web of challenges with four main drivers: the legacy of four decades of conflict, climate-related crises like floods and droughts, natural disasters such as earthquakes, and underlying economic fragility. 

The economic shock caused by the international withdrawal in August 2021, dependence on humanitarian aid, and restrictive policies—especially those limiting the rights and freedoms of women and girls—have further compounded these challenges. Over 6.3 million Afghans are displaced, and 23.7 million are in need of humanitarian assistance.

One of those deeply affected by these circumstances is Fatima, a 44-year-old mother of nine from Faryab province. “We had to rely on the little money we earned from weaving carpets to seek medical care,” she recalls. “If we couldn’t make it to a clinic in time, our children could die.” 

Her words reflect the struggles of the 8.7 million people in Afghanistan who require healthcare support.

Fatima's younger daughter, Sabrina, became severely malnourished a few months ago. The family’s village had no nearby clinic, forcing residents to travel to the city for medical support—a journey that came with prohibitive transportation costs. Like many in her community, Fatima’s family could not afford these expenses. Borrowing money for transportation or treatment was not a sustainable solution.

“Due to our financial struggles and the fact that I have nine children, we were unable to feed them properly, which led to my daughter’s malnutrition,” Fatima shares. “It was a difficult time for me. We initially took her to a clinic in the city, but we couldn’t afford the full treatment, so it wasn’t effective.”

In response to this kind of exclusion, the DAWAM (Driving Action for Wellbeing to Avert Mortality) consortium, led by World Vision UK, is transforming lives by increasing access to lifesaving healthcare and nutrition support, while also investing in complementary provision of water, sanitation and hygiene (WASH) facilities to reduce waterborne diseases that can drive malnutrition. The consortium, which includes four international partners (Action Aid, Action Contre la Faim, BBC Media Action, and World Vision Afghanistan) and three local partners (Agency for Assistance and Development for Afghanistan, Afghan Women’s Educational Centre, and Nai Qala Association), is committed to reducing morbidity and mortality among vulnerable groups, including women, girls, and people living with disabilities (PLWD).

Funded by the UK government’s Foreign, Commonwealth, and Development Office (FCDO), DAWAM operates in some of Afghanistan's most remote and underserved provinces: Badakhshan, Badghis, Daikundi, Faryab, Ghor, Herat, Nangarhar, and the capital Kabul. Over the course of its implementation from October 2023 to March 2026, DAWMA will be prioritising the integration of health, nutrition, and WASH services in hard-to-reach areas.

One of the areas benefiting from these integrated services is Fatima’s village in Faryab. When World Vision Afghanistan established a health and nutrition facility there, it was a turning point for families like Fatima’s.

Fatima recalls the moment she brought Sabrina to the facility, “After four rounds of treatment for malnutrition from this centre, Sabrina recovered and became healthy.” This recovery marked a significant improvement in Sabrina’s health and brought immense relief to her family.

Two months after Sabrina’s recovery, she developed pneumonia. Once again, Fatima turned to the World Vision health facility for help. The staff not only provided the necessary treatment and medication but also offered guidance to Fatima on how to care for her daughter at home.

Fatima's story is just one among many that illustrate the critical role of these integrated services. She expresses her gratitude, sharing, “If we couldn’t make it to a clinic in time, our children could die. We are very grateful for the services of this clinic. We kindly request that it continues to operate for a longer period, so we and others in the community can keep benefiting from its health services. Without this clinic, we would have no choice but to endure more suffering, as we cannot afford transportation or treatment elsewhere.”

Through these services, nine-month-old Sabrina’s life was saved, and Fatima was spared the financial strain of taking a loan for transportation and treatment. The clinic’s presence has eased a significant burden on families who previously faced impossible choices between life-threatening illness and life-threatening poverty.

The success of the health and nutrition facility in Fatima’s village underscores the importance of integrated programming in Afghanistan. By addressing health, nutrition, and WASH issues collectively, the DAWAM consortium is not only saving lives but also empowering communities to build resilience against future challenges.

While the DAWAM project is still in its early stages, its impact is already evident. Families like Fatima’s now have access to essential services that were once out of reach, enabling them to break the cycle of suffering and deprivation.

Fatima’s heartfelt words reflect the sentiment of many, “We are so thankful for this clinic. It has given us hope and saved our children’s lives.”

As DAWAM continues its mission, it remains a beacon of hope for vulnerable communities across Afghanistan, ensuring that no one is left behind in the fight for better health and wellbeing.