Context
From the start of 2020, the COVID-19 pandemic had been affecting the daily lives of people globally, including Afghanistan. However, Afghanistan faced additional challenges due to the lack of resources and limited support from the international community. The mental health and psychological well-being of the general public significantly declined due to the impact of the COVID-19 pandemic. High levels of anxiety and fear were prevalent among the masses, compounded by economic difficulties and uncertainty.
Service users and their family members
Service users and their family members experienced heightened stress and anxiety. This affected the ability of service providers, especially frontline workers, to effectively carry out their jobs and provide follow-up care to patients. The emotional burden placed on these providers by their families created additional challenges in delivering quality care.
Service providers in health and social care
Frontline workers in Afghanistan faced considerable stress and challenges. The uncertainty surrounding the COVID-19 crisis, along with the lack of necessary resources such as personal protective equipment, eroded their confidence. Additionally, there was a lack of trust from the community, and violence from patients' relatives further exacerbated the situation. The low hygiene and disease prevention preparedness of the Afghan population, resulting from a lack of water, sanitation and hygiene infrastructure, contributed to the challenges faced by healthcare workers. Many healthcare workers also experienced traumatic events, adding to their stress levels. However, organizations like the International Assistance Mission were able to save lives by intervening in attempted suicides through counselling, underscoring the importance of this practice.
Challenges
Several challenges impeded the delivery of mental health and psychosocial support (MHPSS) services in Afghanistan.
Accessibility and mobility to remote areas were consistently challenging.
Long-term interventions required more time for families and patients to reach healthcare centers.
There was low awareness and knowledge within the community regarding the mental health aspects of COVID-19.
Some healthcare workers lacked familiarity with the proper usage and disposal of personal protective equipment, increasing the risk of infection transmission.
Due to heavy workloads, healthcare workers at primary healthcare centers struggled to provide adequate psychological support to patients.
Delivering mental health and psychosocial support services (MHPSS) and ensuring continuity
Innovative solutions
Online counselling services were initiated and proved successful.
A TV programme was launched to provide information about mental health.
Healthcare workers received training on psychological first aid and mental health, which was well-received by the community.
Psychological first aid training was also provided to community volunteers and health shoura members.
Brochures on child mental health were printed and distributed.
Lessons learnt
Online psychosocial support and awareness initiatives were easily implemented and widely accepted by the general public during the COVID-19 pandemic, suggesting their continued use post-COVID.
Early awareness and support, such as psychological first aid and information on COVID-19, could significantly reduce stress and harm among healthcare workers and beneficiaries.
Remote support facilities are reliable, safe and sustainable in both the short- and long-term.