FEATURE STORY

Afghanistan Builds Capacity to Meet Healthcare Challenges

December 22, 2015

Image

Doctor treating a patient at Mazar-e-sharif-Dehadi District Hospital

World Bank

STORY HIGHLIGHTS
  • Healthcare in Afghanistan has seen significant gains in the last one and a half decades with notable decrease in the maternal, infant and child mortality rates.
  • The Ministry of Public Health (MoPH) continues to build capacity to extend its coverage of the Basic Health Services and Essential Hospital Services, particularly to the poor.
  • The MoPH intends to further expand the scope, quality, and coverage of healthcare services through the System Enhancement for Health Action in Transition (SEHAT) Program, which is supported by the World Bank and Afghanistan Reconstruction Trust Fund (ARTF).

Kabul Province (Kabul City): From the emergence of a new cadre of professionals to a dramatic increase in the number of children going to school, and a significant decrease in maternal and infant mortality rates, Afghanistan has witnessed tremendous development in the last one and a half decades. With the generous support of the international community, Afghanistan embarked on the path towards reconstruction 14 years ago, especially after several decades of war that left much of the country damaged.

Efforts to nurture an inclusive health care system have been part of the development goals in the past one and a half decades. The MoPH in cooperation with international donors has been working towards creating a well-functioning, efficient, and reliable healthcare system that is capable of offering quality healthcare services for Afghans across the country.

According to the Ministry of Public Health, “ in 2003, only 9% of Afghans had access to healthcare services ,” whereas today, as much as 67% of  Afghans have access to  the Basic Package of Health Services and Essential Hospital Services provided by over 2,200 health facilities  in all 34 provinces.”.

Currently, more than 23,000 volunteer health workers assist MoPH throughout the country and this number is growing constantly day after day. “People have been informed about healthcare issues by volunteers and media and their awareness and information about health issues have increased” Dr. Hassan says.

MoPH runs healthcare centers in Kapisa, Panjsher, and Parwan provinces while providing health services in the rest of 31 provinces of Afghanistan have been contracted out to Non-Governmental Organizations (NGOs) through a robust competitive bidding process.

Initially, many donors funded MoPH through a variety of projects, among which World Bank, European Union, and the United States Agency for International Development (USAID) have remained the Ministry’s main donors.

With a three-year budget of $600 million, all donor assistance was mainstreamed in 2014 through the System Enhancement for Health Action in Transition (SEHAT) Program implemented by MoPH, with support from the World Bank and Afghanistan Reconstruction Trust Fund (ARTF).

The SEHAT Program aims: (i) to expand the scope, quality, and coverage of health services provided to the population, particularly to the poor, across the country, and (ii) to enhance the stewardship functions of MoPH. The program supports the provision of a basic package of health services and an essential package of hospital services in entire country. It also strengthens the national health system and MoPH’s capacity at central and provincial levels, so that the ministry can effectively perform its stewardship functions.

Dr. Abdul Qadir Qadir, Director of Policy, Planning and Public Relations at MoPH, says: “The program’s effective and efficient finance management has allowed for an easy evaluation and supervision. Moreover, it has brought our three main donors under one umbrella, whose funds are channeled to the government budget through ARTF.”


Image

Basic Package of Health Services (BPHS) and Essential Public Health Services (EPHS) are available at Nangarhar Regional Hospital

World Bank

" Today, as much as 67 percent of Afghans have access to Basic Package of Health Services and Essential Hospital Services provided by over 2,200 health facilities in all the 34 provinces. "

Dr. Mohammad Hassan

Acting Director, Grant and Contract Management Unit, Ministry of Public Health

Image

According to the Ministry of Public Health, today 67% of Afghans have access to the Basic Package of Health Services and Essential Hospital Services.

World Bank

Planned Increase of Female Doctors

Prior to the SEHAT Program, each of the ministry’s donors worked separately in Afghanistan’s public health sector, which has diminished the effectiveness of the services being provided. Previously, parallel projects, lack of prioritization, and insufficient oversight had caused problems that led to a mushroom-style progress in health sector. These problems have been resolved under the SEHAT Program, says Dr. Qadir.

In total, 41,500 health professionals work in health centers across the country. “Currently, the ministry’s staff include 18,500 health professionals and the NGOs have a total of 23,000 medical health professionals across the country,” says Dr. Ehsanullah Shaheer, MoPH Director of Human Resources. Female doctors make up 20% of the total number with a planned increase up to 30% in the coming year. Moreover, about 450 health advisors currently work for or under the supervision of the MoPH.

MoPH has had significant achievements in the past 13 years, says Dr. Ferozuddin Feroz, Minister of Public Health. For instance, maternal and infant mortality rates have decreased significantly between 2002 and 2013: mortality rate of mothers dropped from 1,600 per 100,000 to 327 per 100,000, while mortality rate of children under five years of age fell from 257 per 1,000 to 97 per 1,000, and mortality rate of newborns decreased from 97 per 1,000 to 77 per 1,000.

In spite of the aforementioned achievements, almost one third of the population still lack access to healthcare services, mainly due to perpetual insecurity and impassable roads, which have left some remote areas inaccessible, Dr. Feroz states. Likewise, progress in the health sector depends on the level of progress made in other sectors, including security, economy, literacy, and culture. In order for the health sector to progress further, other sectors should also advance, Dr. Feroz says.


Api
Api