Afghanistan’s public healthcare system is vital in providing care to the economically disadvantaged and managing infectious diseases and maternal health problems. In this article KIT epidemiologists and research partners in Afghanistan re-analysed the Afghanistan Health Survey 2018 in combination with data on the quality of public healthcare facilities from a national healthcare facility assessment of the same year. They conclude that the private sector plays a dominant role, particularly for those illnesses not covered under the essential healthcare packages, with strong implications for  health equity.