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This paper uses critical discourse analysis and critical literacy to analyze the first in a series of literacy primers developed with US support for children in Afghanistan in the 1980s, called 'Jihad literacy'. The text is analyzed for its ideological content as related to the themes of religion, violence, and martyrdom in the historical perspective of the Cold War and the Soviet Union's invasion of Afghanistan. The paper demonstrates how the notion of 'Jihad' was subverted to promote a holy war against the Soviet invasion. The educational system supported by the US created a radical version of Islam based on violence and martyrdom, shaping the Afghan society to this day. We contend that the same or similar institutions shape current discourses as in the past and that children are the main victims of politico-economic warfare.

Severe acute malnutrition (SAM) remains a major global public health problem. SAM cases are treated using ready‐to‐use therapeutic food (RUTF) at a dosage of ∼200 kcal/kg/day per the standard treatment protocol (STD). Emerging evidence on simplifications to the standard protocol, which among other adaptations, includes reducing the daily RUTF dosage, indicates that it is effective and safe for treating children with SAM. In response to a foreseen stock shortage of RUTF, the government of Afghanistan endorsed the temporary use of a modified treatment protocol in which the daily RUTF dosage was prescribed at 1000 kcal/day (irrespective of body weight) until the child achieved moderate acute malnutrition status (weight‐for‐height z‐score ≥ −3 or mid‐upper arm circumference [MUAC] ≥ 115 mm), at which point 500 kcal/day was prescribed until cured (modified treatment protocol [MTP]). In this paper, we report the results of this nonweight‐based daily RUTF dosage experience. Data of 2042 children with SAM, treated using either the STD protocol (n = 269) or the MTP protocol (n = 1773) from August 2019 to March 2021 in five provinces, were analyzed. The per‐protocol analyses confirmed noninferiority of MTP protocol when compared to STD protocol for recovery rate [93.3% vs. 90.2%; ∆ (95% confidence interval, CI) = 3.1 (−0.9; 7.2) %] and length‐of‐stay [82.6 vs. 75.6 days; ∆ (95% CI) = 6.9 (3.3; 10.5) days], considering the margin of noninferiority of −10% and +14 days, respectively. Weight gain velocity was smaller in the MTP protocol group than in the STD protocol group [3.7 (1.7) vs. 5.2 (2.9) g/kg/day; ∆ (95% CI) = −1.5 (−1.8, −1.2); p < 0.001]. The STD group had a significantly higher mean than the MTP group for absolute MUAC gain [∆ (95% CI) = 1.7 (1.0; 2.3) mm; p < 0.001] and the MUAC velocity [∆ (95% CI) = 0.29 (0.20; 0.37) mm/week; p < 0.001]. Our results confirm the noninferiority of a nonweight‐based daily dosage and support the endorsement of this modification as an alternative to the standard protocol in resource‐constrained contexts. Key messages: More evidence supporting the use of the nonweight‐based daily ready‐to‐use therapeutic food (RUTF) dosage for treating uncomplicated severe acute malnutrition (SAM), in specific contexts, is needed.Our real‐world prospective nonrandomized study showed that the fixed nonweight‐based daily RUTF dosage protocol is as effective as the standard weight‐based protocol for treating uncomplicated SAM in children <5 in the Afghanistan context.Our findings support the reflection of a nonweight‐based daily RUTF dosage in resource‐constrained contexts in national and global policies and guidelines to improve coverage of all children in need of treatment. [ABSTRACT FROM AUTHOR]

Iran has been among the top ten largest refugee‐host countries worldwide, sheltering one of the largest groups of forced migrants from Afghanistan during the past four decades. This policy paper briefly examines and summarizes the policies related to education of Afghan children in Iran through a structured review. The results of this review suggest that higher education has been and continues to be heavily restricted for Afghans. While access to primary education has improved for Afghans in Iran, policies continue to neglect both cultural specificity and unique needs of this group. Therefore, enrolment has remained restricted. The findings of our policy analysis call for further attention to culturally relevant education, financial assistance for families living in poverty and interventions to subsidize the cost of education to ensure access of all Afghan children to primary education and retain enrolment. Results also call for reconsiderations in restrictive higher education policies for Afghans in Iran. [ABSTRACT FROM AUTHOR]

Background: The prevalence of pediatric mental illnesses has been increasing in recent years, with a great potential to impact on individual's functionality and adaptation in adulthood. Objective: This study aims to assess emotional and behavioral problems among schoolchildren in Herat City of Afghanistan. Methods: This cross-sectional study was conducted on schoolchildren (grade 5-10), between September and November 2021. Sociodemographic data was collected using a paper-based 14-item structured questionnaire. Data on emotional and behavioral problems was collected using the Strengths and Difficulties Questionnaire (SDQ) based on teachers' and children's report. Statistical analyses were performed in IBM SPSS Statistics (version 27). Results: A total of 418 students, including 190 (45.5%) males and 228 (54.5%) females with a mean age of 14.1 ± 1.7 (11 < 18) years were included in the study. The prevalence of students' self-reported total difficulties and prosocial problem were 5.7% and 1.2%, respectively. An insignificant difference was observed between mean total difficulties scores between students' self-reported and teachers' reported SDQ. Gender, grade, concern about shortage of food, and concern about losing house were significantly predicting students' self-reported total difficulties scores. Conclusion: This is the first study to report the prevalence of emotional and behavioral problems among schoolchildren in Herat City, Afghanistan. This, together with relevant global literature, highlight the need to address pediatric mental health, and provide services aimed at preventing, and treating children with these problems around the world. [ABSTRACT FROM AUTHOR]

Background Tuberculous meningitis (TBM) is the most severe form of TB. We prospectively documented the treatment outcomes and the risk factors for death in children with TBM from Kandahar, Afghanistan. Methods This prospective observational cohort study was conducted from February 2017 to January 2020 in hospitalised TBM children. All the patients were prospectively followed up for 12 mo. Data were analysed by using descriptive statistics, χ2 and multivariate logistic regression. Results A total of 818 TBM hospitalised patients with median age 4.8 (0.8–14.5) y were recruited. Females accounted for 60.9% (498/818). Upon admission 53.9% (n=441) and 15.2% (n=124) had TBM stages II and III, respectively, and 23.2% (n=190) had focal neurological signs. The case fatality rate was 20.2% (160/794) and 30.6% (243/794) survived with neurological sequelae. Independent risk factors for death were being unvaccinated for BCG (adjusted OR [AOR] 3.8, 95% CI 1.8 to 8.1), not receiving dexamethasone (AOR 2.5, 95% CI 1.5 to 4.2), being male (AOR 2.3, 95% CI 1.5 to 3.6), history of recent weight loss (AOR 2.2, 95% CI 1.3 to 3.9) and having stage III TBM (AOR 2.0, 95% CI 1.2 to 3.3). Conclusions TBM continues to cause high morbidity and mortality in Afghan children. Strategies to reduce mortality should emphasise early diagnosis and treatment, routine use of dexamethasone and increased BCG vaccination. [ABSTRACT FROM AUTHOR]

In this study we evaluate the impact of a literacy program for internally displaced female refugees in Afghanistan. The results of the evaluation show that the program was beneficial both for the women who received it and for their children, as participants were 50% points more likely to be able to read and write and 19% points more likely to work. The program also had positive effects on their children who were 2.6% points more likely to be enrolled in secondary school. Overall, the evaluation results suggest that adult literacy programs may mitigate intergenerational poverty traps. [ABSTRACT FROM AUTHOR]

Background: Soil-transmitted helminth (STH) infections are still a major health problem, especially in resource-limited countries. The community-based prevalence of STH is unknown in Afghanistan. Main objectives of this study were to estimate the prevalence and associated factors of STH among children in Daman district of Kandahar province in Afghanistan.Methods: This was a community-based cross-sectional study, with data collected during five months (June-October, 2020) from children living in five villages of Daman district in Kandahar, Afghanistan. All the stool samples were examined by saline wet mount method. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression.Results: A total of 1426 children were studied, with majority (61.8%) of males and the mean age of 6.3 years. The overall prevalence of any intestinal parasitic infection was 39.8%. The overall prevalence of STH infection was 22.7%, with Ascaris lumbricoides (18.7%) as the most prevalent STH species, followed by hookworm (7.5%) and Trichuris trichiura (1.4%). Single, double, and triple STH infections were present in 14.9%, 7.2%, and 0.6% of the children, respectively. Multivariate logistic regression revealed that not washing hands after defecating/before eating (AOR 7.0, 95% CI 3.4-14.0), living in mud house (AOR 3.5, 95% CI 1.6-7.4), walking barefoot (AOR 2.2, 95% CI 1.6-3.1), living in overcrowded house (AOR 1.6, 95% CI 1.1-2.3), and practicing open defecation (AOR 1.4, 95% CI 1.1-2.0) as the risk factors associated with the predisposition of rural children for getting STH in Daman district of Afghanistan.Conclusions: Prevalence of STH is high among children of Daman district in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan. Also, government and international donor agencies in Afghanistan should help in improving socio-economic status of the rural areas through provision of basic facilities such as piped water, electricity, good housing, and proper toilets. [ABSTRACT FROM AUTHOR]