Since 2001, the Afghan population's access to basic services has greatly improved in nearly all areas. School enrolment has increased sharply, with over eight million children currently enrolled in school, of which 39 percent are girls. Current strategies for improving sub-national service delivery focus on delegating greater authority to provincial and district administrations.
This report aims to identify administrative constraints in three key sectors of public service delivery, education, health and agricultural extension services. The analysis follows the service delivery chain, from central to provincial, through district to community level, and is particularly concerned to examine service delivery in these three sectors through the window of sub-national governance and its relations to the service delivery mandates of line ministries.
The study provides the Government of Afghanistan with recommendations on how to alleviate critical constraints to service delivery at sub-national levels on a sustainable basis, in the context of an expected restrained fiscal future. The report's main findings are based on qualitative research. The key findings are based on existing literature and reports as well as field visits to 5 provinces and 10 districts and qualitative analyses of over 171 key-informant interviews on different levels of service delivery administration, 68 in-depth interviews with community leaders, and a community household survey in 20 communities spread over 5 provinces and 55 service facilities (for example, schools and clinics) were assessed.
The report is split into six sections: section one gives executive summary; section two provides a brief introduction to the study objectives and clarifies some key definitions; section three outlines the methods used to perform the analysis; sections four, five, and six provide in-depth discussions of education, health, and agriculture extension respectively; and section seven provides recommendations and concludes. The over-arching governance structures and further methodological details are given in appendix one.
Policy recommendations that apply to all sectors include:
- Ministries to develop and disseminate clearly defined policies for O&M budgeting, distribution and guidelines for prioritization.
- The central level to support and monitor O&M expenditures within provinces to improve distribution, and identify sub-national capacity building needs.
- The sub-national governance framework should be clarified so that roles and responsibilities regarding management and accountability of the provincial line department are clear.
- Ministries to develop clear, comprehensive and measurable service standards for their services, and communicate these standards to sub-national levels so that awareness is raised, and sub-national accountability is strengthened.
- Improve financial information flows and disaggregation of district budgeting and expenditure data through adoption of district location codes in the Chart of Accounts.
Public Education
- Increase the scope of indicators included in the EMIS self-reporting system.
- Strengthen existing internal monitoring and reporting systems.
- Verify monitoring and reporting accuracy through regular third party evaluations independent of the Ministry.
- Improve the correlation between provincial teacher training plans and provincial needs.
- Improve the transparency of teacher recruitment and appointment processes.
- Develop a targeted incentive program to improve teacher capacity in the most remote and insecure districts.
Public Health
- Strengthen MoPH management authority over its provincial line departments including discretion over appointment and removal of provincial directors.
- Strengthen and intensify HMIS verification systems and improve data organization.
- Create a ‘citizen’s public health policy’, a simplified BPHS policy, and communicate to sub-national levels.
- Strengthen pharmaceutical regulation and monitoring.
- Decrease the occurrence of prolonged drug stock-outs in public health.
Agricultural Extension Services
- Develop a strategy including feasible objectives and measurable indicators that recognizes the flat and even reducing budget environment.
- Strengthen role of the Ministry as a sector regulator through the development of minimum standards and the use of a ‘contracted out’ modality for key extension services.
- Develop a joint work plan for the research and extension directorates to strengthen technical and dissemination capacity.
- Design a national program for extension directorates to use radio and TV broadcasting to share knowledge with farmers.
- Create communication material for agricultural extension to be applied selectively across provinces in farmer trainings as well as campaigns in bazaars.