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Based on available COI, the general situation with regard to the elements mentioned above is assessed as follows:
Food security [Key socio-economic indicators 2020, 2.4, 2.7.1]
In Afghanistan’ population of approximately 33 million, it was reported in September 2019, that 3.9 million were in need of emergency food and livelihood assistance since they were affected by the 2017-2018 drought, while 13.5 million were severely food insecure, having limited food production, depleted assets and livelihoods, reduced incomes and weakened health. According to the 2019 Integrated Food Security Phase Classification (IPC) report, 10.2 million of the Afghan population were acutely food insecure, while 11.3 million would need humanitarian assistance in winter 2020-2021. Despite the passing of the drought, it was estimated that almost 14.3 million people were to be in either crisis or emergency food insecurity (IPC 3 and 4) from November 2019 to March 2020. An increase in prices was reported in March 2020, following the border closures and export restrictions related to the spread of COVID-19. Following the introduction of lockdown measures and increase in domestic demand, Famine Early Warning System (FEWS) reported on the rise of prices in late March and early April, stating that many households are expected to be unable to meet all food and essential non-food needs as their purchasing power has reduced.
According to a report of April 2020, households located in Kabul, Herat, and Mazar-e Sharif - as well as those in other major cities - and dependent on small business or petty trade, remittances, non-agriculture wage labour, and low salary jobs, were the worst affected by the reduced access to employment and significantly increased food prices.
The main variable in access to food are the means of subsistence available to the applicant, which in the case of displaced persons can be a particular concern.
Housing and shelter [Key socio-economic indicators 2020, 2.7.1, 2.7.3]
According to recent information, around 8 million (24.4 %) of the Afghan population live in urban areas and around 23.4 million (71%) are inhabitants of rural areas. Kabul has been the centre of the growth, and the rest of the urban population is concentrated mostly in four other city regions: Herat, Mazar-e Sharif, Kandahar and Jalalabad. The large majority (72 %, based on Afghanistan Living Conditions Survey figures for 2016-2017) of Afghanistan’s urban population lives in slums or inadequate housing. Most housing in Afghanistan consists of irregular, detached, or semi-detached houses or regular detached houses. A large proportion consists of hillside dwellings. The majority of Afghans generally live in very poor housing conditions and have minimal access to housing financing.
Designed for about a million people, Kabul was reported to accommodate more than five million people, settled in the capital and around it in a non-regulated way. In 2018, an estimated 70 % of Kabul’s population was reported to live in informal settlements defined as areas of housing either constructed on land to which the occupants have no legal claim, and/or areas of housing units that do not comply with planning and building regulations. The city’s informal settlements were reported to offer crucial low-cost housing to the majority of residents. According to a survey in 2016-2017, Kabul was the only location, in which renting was a common practice.
The urban density in Herat City was reported as very high as of 2015 and the settlements pattern was quite regular although most buildings did not conform to a master plan. In 2016, an estimated 5 % of the city’s population was reported to live in soft structures or tents. As the north-western provinces of Afghanistan were particularly affected by the drought conditions of 2017-2018, Herat and Badghis provinces were the destination for over 60 000 people who became displaced and resided in overcrowded camps in and around Herat City.
According to a 2015 survey, 66.5 % of inhabitants of Mazar-e Sharif owned their houses, while 24.5 % rented their accommodation. More than half of the houses in the city were constructed from mud or soil with wood logs, the rest from lime with bricks and metal, cement, or other materials.
Hygiene, including water and sanitation [Key socio-economic indicators 2020, 2.7.3]
A 2020 report found that most Afghans lacked a safe water supply, adequate sanitation, and hygiene, and the vast majority of the Afghan population had limited access to electricity, especially in rural areas. According to UNOCHA, only 67 % of the population had access to at least basic (improved) drinking water services as of 2019, with huge disparities between urban (96 %) and rural (57 %) population groups. UNOCHA also noted that only 43 % of the population had access to basic sanitation facilities: 57 % of urban dwellers and 38 % of rural inhabitants.
The increase in water consumption and decrease of the quality of groundwater caused a deficiency of water in Kabul. It is estimated that 32 % of Kabul’s population has access to running water, and only 10 % of residents receive potable water. The city’s inadequate water system forced those people who could not afford it to drill their own wells. Many poor residents of Kabul depend on public taps, often far from their homes. Besides problems in the water supply, the provision of other basic services, e.g. sanitation and electricity, to the growing informal settlements that emerged on the centrally located hills of Kabul, was reported to be difficult. Kabul remained one of the world’s few national capitals without a central sewerage system, which caused human pollution and health problems.
Of the urban population in Herat City, 81 % was reported to have access to improved water sources, 90.7 % used electricity as a source for lighting and 92 % had an improved sanitation facility. The majority of residents in Herat City drew their drinking water from pipes or wells. The city was reported to lack a central sewage system and the leakage of sewage into groundwater was considered as a main cause of water contamination in the city.
Most people in Mazar-e Sharif have access to improved sources of drinking water (76 %), usually piped or from the wells. Around 92 % of households have improved sanitation facility.
Basic healthcare [Key socio-economic indicators 2020, 2.6.]
Despite improvements, Afghanistan’s public healthcare system, neglected during the years of conflict, continues to face challenges, such as damaged infrastructure, a lack of trained healthcare providers and under-resourced healthcare facilities. The World Health Organization (WHO) reported that in 2018, 3 135 healthcare facilities in total were functioning, ensuring access to healthcare to approximately 87 % of the population within a two-hour distance. According to a recent report, the population of Afghanistan is still struggling to get access to healthcare, because of pervasive violence, widespread poverty, and a weak public health system. Even though the majority of the population has access to primary healthcare, large sections of Afghanistan’s rural population still do not have access to essential healthcare services.
Corruption and hidden costs also constitute a significant barrier to the access in healthcare. Although healthcare should be free of charge, people have to pay for medications, doctor’s fees, laboratory tests, and inpatient care in many public facilities. High treatment costs were the main reason treatment was avoided. Those who can afford, refer to private healthcare providers or travel abroad to get treatment.
Availability of medicines and medical equipment is limited due to insecurity, inaccessibility of roads and disruption of electricity or temperature-controlled supply chains. It was also noted that healthcare facilities in Afghanistan frequently have issues with getting medication. Medicine quality was also a significant issue.
In addition, lack of adequate healthcare services for particular vulnerable groups, such as persons with psychological/mental health conditions or persons living with disabilities, as well as women, is still a major concern.
With regard to the COVID-19 outbreak, it was highlighted that Afghanistan is particularly vulnerable, due to its limited healthcare system and few medical personnel, weak infrastructure, and poor social cohesion after 40 years of war, along with a large influx of refugees returning from Iran and Pakistan - without proper quarantine and containment measures in place. At the end of March 2020, in the main COVID-19 hospital in Herat supplies were reportedly scarce despite funds received from the government for tackling the pandemic. UNOCHA reported that some health services, such as routine vaccinations, the polio programme, antenatal care, mental health and psychosocial support, had been either suspended or reduced due to COVID-19.
The WHO reported in 2018, that of 135 hospitals in Afghanistan, 26 are located in Kabul. As noted by a 2019 report, the large numbers of people arriving in Kabul have resulted in limited access to basic healthcare, particularly for those who cannot afford to go to private hospitals. According to another report, 33 % of the households in Kabul reported not having access to a healthcare centre – public or private, mainly due to the very high cost of services. There was no private mental healthcare institution in Kabul providing inpatient treatment, but two public institutions offered this kind of treatment for free. However, medication might not be available in the hospitals free of charge. Psycho-social assistance free of charge was also offered by an NGO for those who needed psycho-social help, but it was stated that the organisation had limited resources and services.
Herat Regional Hospital, located in the centre of Herat City, was the main hospital serving the provinces of Herat, Badghis, Ghor, Farah and Nimroz, with specialised tertiary level health services. It is reported that a public hospital providing free outpatient and inpatient treatment by a psychiatrist or psychologist is located in the city, with the possibility of free medication if available. UNOCHA reported in September 2018, that basic and secondary healthcare facilities in Herat City had become insufficient to cope with the large numbers of IDPs that had come to Herat City.
There were approximately 10-15 hospitals in Mazar-e Sharif, most of them private, and 30-50 health clinics, as of 2018. The Abu Ali Sinha Balkhi Regional Hospital in Mazar-e Sharif served as the central hospital for Balkh province and was the referral hospital for the northern region, receiving all accident and emergency cases and acting as a major general hospital for the clinics in the surrounding districts. It was reported that there were two facilities providing mental health service in Mazar-e Sharif.
Means of basic subsistence [Key socio-economic indicators 2020, 2.2.2]
The International Labour Organization (ILO) modelled estimates for 2020 show an increase in unemployment rates in Afghanistan compared to 2019 and 2018, indicating the total unemployment rate (people aged 15+) at 11.2 %, with youth unemployment (aged 15-24) estimated at 17.5 %. In 2019, the overall unemployment rates were estimated at 11.1 % and youth unemployment (aged 15-24) at 17.4 %. While the participation of women in labour force was low, their unemployment rate was extremely high. Furthermore, unemployment has a seasonal character: the unemployment rate is relatively low during spring and summer months (around 20 %) but reaches almost 33 % in the winter. Young Afghans enter the labour market in large numbers every year, but employment opportunities cannot keep up with the population growth because of inadequate development resources and poor security [Key socio-economic indicators 2020, 2.2., 2.2.1, 2.2.4].
Afghanistan faced a sharp increase in poverty since 2011-2012, with a rise in both urban and rural poverty rates. In 2016-2017, 54.5 % of the population was living below the national poverty line. UNOCHA estimated that over 80 % of Afghans lived on less than the internationally applied poverty line (USD 1.90 per day) in 2019. The World Bank expects poverty to remain high in 2020, due to weak labour demand and security-related constraints on service delivery. In general, poverty in Afghanistan had a seasonal character, in which welfare deteriorated in winter months due to increase in prices, particularly food, and a decline in income-generating opportunities in agriculture. The World Bank also reported that rural poverty remained consistently higher than urban poverty. Increasing numbers of people resort to negative coping mechanisms such as petty crime, child marriages, child labour, and street begging, particularly affecting IDPs [Key socio-economic indicators 2020, 2.3.1].
As of 2018, ILO defined 66 % of employment as vulnerable and noted that most of the vulnerable workers had own-account status and were more likely to face low job and income security and lower coverage by social and employment protection systems.
Almost 53 % of the rural population is employed in agriculture, while there is more diversity in urban employment, where 36.5 % of the working population is engaged in various services and only 5.5 % in agriculture. Salaried employment in public or private sector held less than 20 % of all employed persons.
As a major trade and employment hub in Afghanistan, Kabul attracts labourers from small villages, who commute to the capital of a daily or weekly basis to trade agricultural products or work as guards, household staff, or wage labourers. The capital has a large share of salaried workers, while self-employment is less common compared to rural parts of the country. Salaries in Kabul are generally higher than in other provinces.
In Herat City, there are opportunities related to trade, import and export of goods, mining, and manufacturing. Approximately half of the working population are day labourers.
Mazar-e Sharif is a regional trading centre for northern Afghanistan and an industrial centre with large-scale manufacturing operations and a huge number of small and medium enterprises providing handicrafts, rugs, and carpets. Mazar-e Sharif is considered relatively more stable compared to Herat or Kabul. The largest group of workers in the city were service and sales workers.
In the context of Afghanistan, different types of networks can be identified, the ones of particular relevance being the relatives (extended family), but also networks based on common background or common work or educational experience. It is, for example, reported that the recent settlements in Kabul are often composed of residents with a common regional or ethnic background, who lean exclusively on each other to find housing and jobs. Sources report that extended family networks were vital for returnees in finding and maintaining employment and housing; however, having a family network did not necessarily remove all vulnerabilities. For unaccompanied minors, single women and female-headed households, vulnerabilities were higher even with family support. Many returnees, particularly those without family connections, settled in cities assuming that those were safer and livelihood opportunities were better [Networks; Key socio-economic indicators 2020, 2.2.3].
Where relevant, available reintegration assistance for forced returnees may also be taken into account as an additional factor, temporarily contributing to reintegration in Afghanistan.
Impact of the COVID-19 pandemic
In its Afghanistan Development Update issued in July 2020, the World Bank stated that COVID-19 measures have significantly impacted industry, services, and business activities, causing declines in remittances and job losses. Afghan officials stated that around 35 000 – 36 000 shops and factories were to be closed in Herat due to movement restrictions, while ‘hundreds of thousands’ of people lost their jobs. It was also reported that in Balkh province the COVID-19-related lockdown downturned about 80 % of the economy and business deals in the province. Per capita GDP is expected to fall sharply - by 13 % by 2021 - estimating to remain below pre-COVID-19 levels for the medium-term. As a result, lower incomes are expected to lead to a deterioration in employment and poverty outcomes, with the poverty rate potentially reaching 73 % over 2020. The high number of returnees and IDPs is also putting pressure on the limited services and employment opportunities in main urban centres.
FEWS estimated that COVID-19 lockdown measures brought a reduced access to income and weakened purchasing power in urban areas of almost all provinces. In April 2020, FEWS reported on a significant decrease of access to income of poor households, which, in general, earned income from daily wage labour and other small trades and which were affected by the restrictions of movement, imposed by the government in main cities [Key socio-economic indicators 2020, 2.1.2, 2.2.2.].