This document contains a PEST analysis of Afghanistan's healthcare industry. It identifies several key political, economic, social and technological factors impacting the industry. Politically, corruption and a lack of employment legislation hinder development. Economically, low income distribution and high inflation create challenges. Socially, traditional norms prevent access to care. Technologically, deficiencies in telecommunications and medical equipment limit services. The analysis recommends public-private partnerships, encouraging internal investment, developing a healthcare financing strategy, and promoting inter-ministerial collaboration to help improve the industry.

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Individual assignment
Afghanistan’s Healthcare PEST analysis
BM003-3-1-BENT
Business Environment
UC1F1611BM
Hand out date: 25 May 2017
Hand in date: 04 July 2017
Weight: 50%
Lecture: Ms. Wong Huey Wern
Student: Mohammad Rasol Faqiri
TP number: 043974
Date: 04/7/2017 Word count:(1523)

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Table of Contents
1.0 INTRODUCTION (BACKGROUND)...................................................................................................... 3
2.0 PEST ANALYSIS OF THE HEALTH INDUSTRY IN AFGHANISTAN..................................... 3
2.1 POLITICAL IMPACTS ............................................................................................................................... 3
CORRUPTION.........................................................................................................................................................3
SOCIAL AND EMPLOYMENT LEGISLATION..............................................................................................................4
2.2 ECONOMIC IMPACTS.................................................................................................................................... 4
LEVEL OF INCOME DISTRIBUTION.....................................................................................................................4
LOW INCOME VS HIGH INFLATION.........................................................................................................................5
2.3 SOCIAL IMPACT ............................................................................................................................................. 5
SOCIAL NORMS.....................................................................................................................................................5
2.4 TECHNOLOGICAL IMPACTS....................................................................................................................... 5
TELECOMMUNICATION ...........................................................................................................................................6
MEDICAL EQUIPMENT............................................................................................................................................6
3.0 RECOMMENDATIONS FOR FURTHER DEVELOPMENT ................................................................... 6
PUBLIC-PRIVATE PARTNERSHIPS...........................................................................................................................6
ENCOURAGE INTERNAL INVESTMENTS...................................................................................................................6
DEVELOP AN EFFICIENT HEALTHCARE FINANCIAL STRATEGY..............................................................................6
ADVOCACY FOR INTER-MINISTERIAL COLLABORATIONS.......................................................................................7
4.0 CONCLUSION................................................................................................................................................... 7
REFERENCES ....................................................................................................................................................... 8

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PEST Analysis of the Health Industry in Afghanistan
1.0 Introduction (background)
Afghanistan is a democratic country in Central Asia, where the president is the head
of the State. For many years, the country’s internal conflicts have caused political and
economic instability, hindering development and progress. Politically, the country
topped the list in terms of instability and corruption with its economy and
fundamental infrastructures mainly fuelled by foreign aids. The lack of education and
professional healthcare personnel, coupled with inadequate healthcare equipment and
technology, pushed its healthcare industry to a dire strait, needing an immediate
overhaul.
2.0 PEST Analysis of the Health Industry in Afghanistan
According to the World Health Organization, Afghanistan has one of the worst health
conditions in the world (World Health organization, 2017). Life expectancy in
Afghanistan is 65 years, and based on a UNICEF report, in every ten children, one
dies before the age of five. 50% of the population still drink water from streams and
contaminated sources, 35% lack nutrition and nearly half of them are malnourished.
Another World Bank Survey in 2015 shows very slight improvement in the country’s
economy since 2002 (Afghanistan: Helping Support Growth and Stability, 2017).
Nearly half of the population is earning less than a dollar per day and 35 million
Afghans (35.8%) are under strict poverty. The influence of PEST; namely, Political
Situation, Economical Condition, Social Factors and Technological Barrier, is
obvious in many aspects of the Afghan society; especially in its health industry.
2.1 Political Impacts
According to the Globalization and Health Research, Afghanistan is one of the most
fragile and conflict-affected f a proper healthcare eco-system in the country.
Some of the key political factors affecting the health sector include the following:
Corruption
In 2016, Transparency International ranked Afghanistan 169 out of a total of 176
countries, in terms of corruption index (Anon., 2016). Corruption has been very
prevalent in the country even down to the village level. For example, in my

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hometown in central Afghanistan, there has been a lack of drinking water.
Whenever any humanitarian or government agencies try to build pipelines to carry
clean water to supply to the villages, they soon found themselves at the mercy of a
local powerful warlord who would demand for a share in the project funds, which
eventually led to a failure in the execution of these projects due to
mismanagement of funds.
Social and Employment Legislation
The literacy rate in Afghanistan stands at a mere 31.7%. This inevitably leads to a
lack of professionals, especially health care specialists. Without proper
employment law and regulations and with its unemployment rate among the
highest in the world. It is not uncommon that an uneducated traditional herbalist
healer, an amateurish dentist or even a vet, becomes a general practitioner. In
many hospitals, many non-medically trained staff and graduates are working as
nurses and pharmacists. These pose a lot of problems in the health sector. It has
resulted in thousands of people spending millions of dollars to seek medical
treatments in neighbouring countries like India and Iran every year.
2.2 Economic Impacts
From the economic perspective, Afghanistan has the lowest GDP in the world. Based
on World Bank data, its annual GDP growth is 0%. This adversely affects the
government’s investment in the health sector.
Level of Income Distribution
It is a fact that in Afghanistan, the poor are getting poorer and the rich getting
richer. Our policies, inclined towards tribal racism and sectarianism, have
widened the gap between sects and ethnic groups in the country. Resources are
channelled to a specific dominating tribe, rocking social harmony and causing
suffering to other ethnic groups. For instance, the government’s annual budgeting
is carried out based on the size of each ethnic group, resulting in nearly 60% of
government spending catering to only one specific group of people. This uneven
distribution of funds causes only certain regions to benefit. In places where the
minorities dwell, public health facilities and services are either lacking or non-
existent.

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Low Income vs High Inflation
In Afghanistan, the work force is grouped into 3 levels of their income. The Low-
Income Group typically make less than USD100 per month, while the Middle and
Higher Income Group earn up to and above USD300 per month respectively. It is
often inevitable, when income is low and expenses are high, that people take risks
or resort to illegal means to make ends meet. An Afghan friend once told me that
he had to sell illegal medicines to make enough to support his family. Under
financial pressure, illegal and expired drugs and medication often floods the
market, retailing at a much lower price. Unfortunately, this creates undesirable
health hazards in communities who are illiterate and plagued by poverty.
2.3 Social Impact
Culture and social norms bring about many challenges to health services too.
Social Norms
In Afghanistan, the elderly and women are often victims of social norms and
unfounded beliefs. For example, Afghans in general forbid men to touch a
woman regardless the reasons. Therefore, a male doctor is usually unable to treat a
female patient in many rural clinics. Even if a woman desperately needs
treatment, it is up to the head of the household, a man, to decide whether she
should see a doctor. As a result, many women were left untreated because the man
is afraid that people would gossip about them. Before 2001, women were not
allowed to go to school. Hence, there are simply not enough women health
workers to serve their fellow women; yet the number of women exceeds men in
Afghanistan. (Anon., 2017) As for the elderly, they are usually not even being
treated in hospitals. People are taught that when they reached a certain age, it is
natural to die. Health issues are but part of a cleansing process of one’s sins. After
this suffering, they will go to heaven. Such deep-rooted beliefs have hindered the
progress of making health services available to every Afghan.
2.4 Technological Impacts
From basic needs like transportation to cutting-edge medical technology, Afghanistan
is way behind the rest of the world. Only 10% of the population live within one hour
of walking distance of health facilities (Anon., 2014) and only 30% of its citizens
have access to 24/7 hours of electricity.

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Telecommunication
The lack of state-of-the-art telecommunication services is just an example of
many technological barriers in Afghanistan. For instance, despite 80% percent of
Afghan residents having access to telephone lines, only 15% of the population has
access to the Internet (Anon., 2014). Although some foreign private clinics like
the German Clinic, perform tele-surgery in its capital Kabul
Medical Equipment, Medical Products, Vaccines, and Technologies are counted
the most efficient fields to carry a satisfactory health service to a country, but in
Afghanistan (Anon., 2015) (Cusano, 2015) many local hospitals do not even
have proper beds, X-ray and laboratory equipment. Which results low pittance
safety in a healthcare industry.
3.0 Recommendations for Further Development
In an unsafe environment, it is hard to recommend practical and effective policies and
strategies for improvements, but there are some pointers worth considering that might
help prevent the health sector from further deterioration.
Public-Private Partnerships (Zeng, 2014)
To improve the health sector in Afghanistan, the government must encourage and
establish a strong Public-Private Partnerships (PPP) by engaging health service
providers in neighbouring countries. Through these PPPs with foreign entities,
Afghanistan will be able to acquire better facilities, advanced technology and
know-how and eventually build its own human capital in health services.
Encourage Internal Investments
Afghans spend millions of dollars every year in India and Pakistan on medical
treatments, worsening its already weak economy. If the government could attract
internal investments and provide them additional facilities based on a Pay for
Performance (p4p) scheme, more private hospitals could be built to provide
adequate and better health services to the people.
Develop an Efficient Healthcare Financial Strategy
The government should keep track of all the medical expenses of its citizens to
accurately analyse and formulate its annual healthcare budget. In this way, more
reliable data and proposals can be submitted to the International Humanitarian
Aids and the World Bank for financial assistance.

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Advocacy for Inter-Ministerial Collaborations (Burhani, 2009)
Internally, the Afghan government should also seek collaboration with religious
leaders and the Ministry of Higher Education to increase health literacy and
awareness among the uneducated, especially those in the rural areas. The Ministry
of Health can also collaborate with the Ministry of Environment to improve
hygiene and healthcare facilities throughout the country.
4.0 Conclusion
The PEST analysis of Afghanistan pertaining to its health industry anticipates a very
uncertain future. Politically the country is unstable with the highest level of corruption
and tribal totalitarianism. Economically, it lacks an efficient strategy to manage its
income distribution and its biased annual budget. Socially, low literacy rate and
strong traditional beliefs are hindering the extension of health services to the rural
areas. Technologically, its lack of modern health facilities, state-of-the-art technology
and, specialized medical personnel contribute to the decline of Afghanistan’s health
sector. Yet amidst such pessimism, the government should proactively seek to
improve healthcare services through Public-Private Partnerships with neighbouring
countries, encourage and incentivize internal investments, formulate a reliable
healthcare budget to garner financial support from the international community and
advocate inter-ministerial collaborations. countries in the world (Matthew Wilkinson,
2016). Three decades of war and its present conflict have destroyed and prevented the
establishment and growth. [word=1522]

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Work cited
References
Anon., 2014. Minisrey of Public Health. [Online]
Available at:
http://moph.gov.af/Content/Media/Documents/AfghanistanHealthIndicatorsFactsheet
Feb2014612201410261651553325325.pdf
[Accessed 26 June 2017].
Anon., 2014. Ministery of communication& Information Technology. [Online]
Available at: http://mcit.gov.af/en
[Accessed 26 June 2017].
Anon., 2016. Taransparancy international. [Online]
Available at: https://www.transparency.org/country/AFG#
[Accessed 22 June 2017].
Anon., 2017. Afghanistan: Helping Support Growth and Stability, KABUL: WORLD
BANK.
Anon., 2017. UNICEF- AFGHANISTAN. [Online]
Available at: https://www.unicef.org/afghanistan/health_nutrition.html
[Accessed 20 June 2017].
Anon., 2017. World Health organization. [Online]
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[Accessed 26 June 2017].
Anon., n.d. [Online]
Available at: www.un.org/en/ecosoc/newfunct/pdf/burhani.pp
Burhani, N. H., 2009. www.un.org. [Online]
Available at: www.un.org/en/ecosoc/newfunct/pdf/burhani.pp
[Accessed June 26 2017].
Cusano, D., 2015. Telecareaware.com. [Online]
Available at: http://telecareaware.com/is-pure-robotic-telesurgery-nearing-reality/
[Accessed 26 June 2017].
Matthew Wilkinson, P. B. P. P. a. R. S., 2016. Globalization and Health. [Online]
Available at:
https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-016-0212-

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[Accessed 26 June 2017].
Zeng, C. K. a. W., 2014. health economics and financing in afghanistan. health
economics and financing in afghanistan, 1(1), p. 3.