IMPACT OF BDN PROGRAM IMPLEMENTATION ON HEALTH IN TWO VILLAGES OF SOUTHERN AFGHANISTAN.

This study focuses on the Basic Development Needs (BDN) survey and the implementation in the villages of two different provinces with focus on key changes over 9 months of implementation of proposed BDN activities. The survey in the two targeted villages before and after the implementation highlights some importance of strengthening the community-based development activities that bring impressive results in the lives of targeted communities. The study was a comparison descriptive quantitative study to measure magnitude, variability of a need or problem and to explore associated factors. Descriptive studies are often guided by questions rather than formal hypotheses, and are often the first step in more directed research. A structured questionnaire was designed based on the goal and objectives. The questionnaire was originally developed in English and then translated into to the local language (Pashto). The questionnaire was divided into two parts for the collection of data on: demographic structure, and health status & economic condition of the population. The intended population of the research was the families of two pre identified villages of Helmand and Kandahar provinces, where BDN programme was not implemented in the past with the aim possible implementation in the near future. Couple were used as surveyors administering a well-designed structured questionnaire. The result of the study, after nine months of BDN implementation indicated significant positive differences in the key indicators in the mentioned villages. The promanent changes in Rawani Village of Kandahar province included still births rate/1000 births decreased from 53 to 39, under one year mortality rate /1000birts from 53 to 43, under five (1-5) mortality rate /1000birts from 9 to 6 and MMR/1,000 LB from 32 to 23, an increase in number of deliveries assisted by trained health staff 185 to 214. Similarly there was positive changes in ANC, PNC, FP and breast feeding in the village. Likewise the improved coverage in immunization was another significant change in village. For instance Penta3 coverage from 36% to 43% and TT2+ from 25% to 28 Similarly the study highlighted the changes determined in Safian Village of Helmand province; these changes were mainly in improved maternal mortality ratio (from 25 to 19), under five mortality rate (1-<5) from 8 to 6/1000, decreased still births rate/1000 births from 41 to 32, deliveries assisted by trained health staff from 76 to 107, routine EPI (Penta3 coverage from 28% to 40% and TT2+ from 28% to 35%). In addition the study indicated tangible improvement in other areas of BDN in both villages, for examples increased access to portable drinking water, access to safe latrines, use of garbage, use a reliable method for irrigation, use of better quality of seeds in agriculture and monthly earnings of families to more 30 US$/month and decreased unemployed adults and attending school by young children increased from 30% to 34%. Even though a systematic sampling was used and all houses in the selected villages were selected, the study still had some shortcomings and limitations, for instance the size of sample of size was too small to represent the whole district and province, the density of households and finding of the participants. In order to minimize these shortcomings the VDCs, CRs and TST were used as helper force to help the surveyors in door to door visits. Generally, as per the study results, the BDN survey and the implementation of the proposed activities based on the BDN approach are quite significant and important to increase awareness of population on the concept of self-help and self-reliance and lead to further cooperation and collective action among the villagers for their well-being and healthy life style. Strengthening of the community-based development activities bring impressive results in the target areas and they will help in further expansion of the BDN programme to neighboring communities. Even though the outcome will be impressive but the pace will be slower as the BDN are development activities that need a lot of time and finance.