Working in close coordination with the health cluster and partners, IOM will sustain and strengthen delivery of essential health care to serve both IDPs and vulnerable returnees, as well as vulnerable members of the surrounding communities, including:

• Deploying mobile health teams providing a comprehensive range of health services inclusive of primary healthcare consultations, emergency stabilization of critical cases, emergency reproductive, maternal, child and neonatal health care (see: MISP), MHPSS services, vaccinations (routine/EPI, alongside COVID-19 and outbreak) supporting the COVID-19 response, referrals for specialized cases and dispensing of free medicines and critical health supplies, including hygiene and menstrual hygiene management kits;
• Implementing targeted health promotion activities and risk communication activities, adapted to the epidemiological situation;
• Deploying Rapid Response Teams (RRTs) for COVID-19, in close coordination with public provincial health directorates, to continue to, and expand support for, disease surveillance efforts for COVID-19, including screening, sample collection and testing, case management and referrals in underserved mobility corridors, border crossing points, IDP settlements and selected institutions, such as public schools, alongside hard-to-reach communities;
• Supporting COVID-19 national vaccination roll-out through mass vaccination programming, logistical or operational support (e.g. non-cold-chain transport) secondment of staff, and/or management of any vaccine-derived adverse effects through IOM’s RRTs and MHTs, alongside facilitating demand generation activities to support COVID-19 vaccine education, and enhance up-take;
• Facilitating tuberculosis (TB) programming through active case finding in hard-to-reach communities, testing and enrolment in treatment.

IOM will further develop its MHPSS programming to meet the massive psychosocial needs arising from widespread and chronic stress and trauma in Afghanistan. MHPSS activities will include:

• Providing counselling (individual and/or group sessions) and basic emotional support through the mobile health clinics, fostering family support and the creation of support groups (e.g., women groups, groups for GBV survivors);
• Training of service providers, NGO staff, health authorities in, psychological first aid (PFA), GBV sensitization and case identification, psychoeducation and sensitization sessions on topics like basic MHPSS knowledge, stress management, self-care, etc, and socio-relational and recreational activities with a therapeutic aim targeting especially children, adolescents and youth, and informal education;
• Providing direct referral of persons in need of specialized mental health services, trauma/GBV cases where necessary, dedicated follow-up for the referred patients, psychoeducation to their families and to the relevant community.

Activities will be provided through mobile health clinics or at any of the available safe spaces within the targeted area. The MHPSS team will ensure that the activities are tailored according to the age and gender categories and are culturally appropriate. All activities provided will be in line with the IOM Manual on Community-based MHPSS in Emergencies and Displacement, and the IASC Guidelines on MHPSS in Emergency Settings.

IOM’s WASH unit will include both technical and public health expertise to ensure timely and appropriate WASH response and services where needed across the country, prioritizing activities that will mitigate the risk of transmittable disease outbreaks, including COVID-19 and acute watery diarrheal (AWD) diseases working in close cooperation with IOM Afghanistan's health teams. This will include:

• Assessment, rehabilitation and expansion of water schemes;
• Management of water schemes through the creation of gender-balanced community-led WASH committees;
• Hygiene promotion and awareness-raising activities, focussing on risk mitigation measures for transmittable diseases, including COVID-19 and AWD/cholera;
• Provision of basic hygiene kits inclusive of menstrual hygiene management (MHM) items.

IOM manages eight reception and transit centres at four major land border crossing points (Nangahar, Kandahar, Herat, Nimroz). These will continue to provide assistance for vulnerable undocumented returnees including:

• Screening and registration, meals, overnight accommodation for up to 72 hours, needed non-food items, multi-purpose cash grants;
• Serving as entry points for a range of critical IOM interventions such as protection, health, disease surveillance at the borders and humanitarian border management, as well as for other partners who also operate within the centres delivering other specialised services, such as mine risk education;
• If feasible and needed, responding to people in need in communities and settlements that may form around border areas, where further movement of people is anticipated as the situation evolves.

IOM will support undocumented returnees and IDPs facing protection risks to return and/or reintegrate in safety and dignity through the provision of tailored emergency assistance at border points and provinces of return. IOM will:

• Work with national authorities to strengthen cross-border protection mechanisms;
• Identify persons with specific needs (including women/children at risk, serious medical cases, persons with disabilities) through protection screeners at Herat and Nimroz border points, in order to refer cases facing protection risks for post-arrival assistance – for instance, provision of information, referrals, and assistance including family tracing and reunification, emergency accommodation, and safe transportation to returnees’ chosen final destination;
• Support safe and dignified return and/or reintegration of undocumented returnees and IDPs in 11 provinces of return through protection case management for households with persons with specific needs;
• Following in-depth case assessments, support households via dissemination of key protection information, referral to local services, and one-off assistance such as cash for protection to meet immediate needs and mitigate protection risks (such as resorting to negative coping mechanisms such as begging, child labour/marriage).

IOM will enhance overall immigration and consular assistance to support needs in the current context through digitalization, including the development of virtual and online tools, flexible and customizable tools for immigration processes, including for resettlement. This will include:

• When feasible, deploying of customized application, biometric and case management solutions in support of well-administered immigration procedures, including visa, ID verification and document issuance, and residence permit schemes;
• Adapting processing capacities to reduce the reliance on in-person procedures through digital and operational tools that could include mobile access points; digitalization; remote interviewing and online support amongst other solutions.

Note that the extent and nature of emergency consular assistance will depend on context and feasibility, as well as the needs of member states. Therefore, no funding requirement is set for this area of activity.

IOM will accelerate delivery of area-based humanitarian, early recovery, reintegration and resilience projects across 150 displacement and conflict-affected communities. This will include:

• Develop district/provincial profiles to guide evidence-based strategic and essential infrastructure projects, to provide communities with basic services while building community resilience to withstand shocks, including those related to climate change and urbanization;
• Undertake participatory community development and action planning to increase civic engagement, strengthen local ownership and identify context-specific solutions for addressing the vulnerabilities of different social groups;
• Support active collaboration and exchange among local stakeholders and community members, particularly vulnerable, marginalised and oppressed groups, to enhance social cohesion and strengthen communities’ response capacities to shocks and stresses;
• Provide emergency livelihood assistance in target communities, including through cash-for-work on construction sites, asset replacement and emergency business grants in support of economic recovery;
• Undertake community-based monitoring and evaluation to promote legitimacy and accountability at local level; 
• Where possible and appropriate, vulnerable individuals who are referred from IOM’s cross-border programmes, in particular protection, will be provided support upon their return to areas where stabilization or durable solutions activities are ongoing.

In the same 150 communities targeted with area-based responses for community stabilization, activities supporting durable solutions will also be delivered. This will include:

• Implement activities that benefit both displaced or returned and host community, while being responsive to the specific (re)integration needs of people on the move, including IDPs, returnees, refugees and rural-urban migrants;
• Implement activities that aim at reducing the root causes of displacement and migration, by strengthening social, economic and psychosocial resilience of displacement affected communities, considering vulnerabilities specific to gender, age, and ability, among others;
• Revitalise local economic conditions by supporting the business eco-system and increasing human capital, thereby safeguarding existing jobs and creating new ones;
• (Re)construct productive and basic social service infrastructure, including health clinics and schools;
• Engage with diaspora communities to foster ongoing linkages and exchange of knowledge, skills, resources and support, connecting groups of Afghans across the world with each other.

In coordination with Health Cluster partners, IOM will:

• Provide acutely needed health system financing support to facilitate operations and help prevent the collapse of the healthcare system, support the financing, running and implementation of critical health facilities and COVID-19 response in targeted provinces, partnering with local implementing NGOs, to help bridge gaps in public health infrastructure;
• Support capacity building efforts for medical personnel in targeted subject areas according to needs, surge/secondment staffing support;
• Advocate to ensure the formulation of migrant sensitive health policies and integrating migrant and displaced populations within national health strategies.

In the same 150 communities selected for an area-based approach, IOM will:

• Provide MHPSS, including awareness-raising on mental and psychosocial health, training community volunteers in psychosocial first aid, and establishing community-based support and referral structures to build capacity for a community-level response that strengthens social cohesion and resilience;
• Support capacity at the community level on social cohesion and resilience through integrated MHPSS activities that include social, ritual and recreational activities that promote relationship-building, trust and problem solving; creation of intercommunal livelihood activities; establish inter-community group sessions and dialogue sessions to prevent violence and analyse potential conflict;
• Provide capacity building to the selected communities on basic conflict mediation skills to expand their capacity to address interpersonal-relationship challenges and community-based conflict-related issues;
• Partner with implementation partners that are connected to the area-based approach and focus on addressing collective trauma and promoting social cohesion through activities such as facilitating community dialogues, assessing and strengthening informal conflict resolution mechanisms and promoting community-led cultural events.

The massive psychosocial needs arising from widespread and chronic stress and trauma in Afghanistan demand sustained efforts to strengthen MHPSS systems. To this end, IOM will:

• Advocate to ensure the formulation of migrant sensitive mental health policies and integrate migrant and displaced populations within national mental health and psychosocial support strategies;
• Promote stronger intersectoral and interagency coordination on MHPSS and participate in the referral mapping of the MHPSS sub-working group at national and provincial levels;
• Support mainstreaming of MHPSS approaches that align with strengthening preparedness and reducing disaster risk;
• Promote the participation of people with disabilities, including psychosocial disabilities, and activities promoting inclusion, in all parts of the disaster risk process: prevention, preparedness including planning, response and recovery.

IOM will sustain and strengthen support at points of entry through the following activities:

• Promote operationalization of the International Health Regulations (2005), alongside IOM's health, border and mobility management (HBMM) approach to operations at points of entry and surrounding communities, contingent on the operating environment and political situation. This includes RCCE activities, health education and promotion, referrals for specialized care, disease surveillance and contact tracing, management of communicable and non-communicable diseases, IPC and strengthening of coordination and partnerships from a multi-sector perspective;
• Deliver appropriate activities, flexible to needs and the operating environment, which will promote preparedness and adequate response mechanisms at borders to protect nationals and foreigners crossing the border while ensuring that security is maintained, with the goal of ensuring well-managed crisis responses, to help prevent the closure of borders, and to assist the international community in effectively responding to humanitarian needs.

IOM’s Displacement Tracking Matrix (DTM) will provide accurate and timely data to IOM and the humanitarian and development community in Afghanistan. DTM tools quantify population sizes, locations, needs, and mobility patterns, as well as the profiles and intentions of migrant, mobile, cross-border and nomadic populations; provide evidence-based metrics on outflows and inflows; and identify at-risk, vulnerable migrants in need of protection services. Activities will include:

• Implement emergency event tracking for real-time information on population movements;
• Undertake flow monitoring at border crossing points;
• Community-based needs assessments and baseline mobility assessments.

DTM data will directly feed into IOM programming, serving as an evidence base specifically for district/provincial profiling, durable solutions and community stabilization.

In addition, IOM’s protection team will:

• Undertake regular protection monitoring (surveys, interviews and community discussions) in coordination with the Afghanistan Protection Cluster to understand the protection environment for undocumented returnees;
• Implement monitoring across all locations to track protection trends, monitor human rights violations, and support analysis to inform evidence-based advocacy for more effective protection and wider crisis response across Afghanistan.