Learn how the World Bank Group is helping countries with COVID-19 (coronavirus). Find Out

FEATURE STORY

Community Health Care Increases Access to Medical Services in Herat Province

November 1, 2016

Investing in Human Capital

As one of 85 health centers in Herat Province, Jebrael health center provides basic health services to about 60,000 people and sees an average of 300 visitors a day, most of whom visit the immunization and general outpatient units.

Photo Credit: Rumi Consultancy / World Bank

Story Highlights
  • The program’s goal to expand scope, coverage, and quality of health services to the population is seeing results in Herat Province. There is greater access to health services as well as an increase in public awareness of health issues.
  • The System Enhancement for Health Action in Transition (SEHAT) Program, under the Ministry of Public Health, supports the provision and improvement of a basic package of health services and an essential package of hospital services to the entire country.
  • The program is supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors.

Enjil District, Herat Province – The baby cries aloud as the nurse administers two vaccines to protect him from the deadly polio virus and tetanus. The nurse tells the baby’s mother, Zahra, not to touch or massage the injection spots. As Zahra’s baby is being immunized, 30 women patiently await their children’s turn.

Zahra, 35, has brought her baby to the health center in Jebrael village in Enjil district for  immunization. She has four children and has decided that she does not want to have any more in the future. “We thought that we would have a better future by having more children,” she says. “But I have learned that having more children does not necessarily ensure a better future.”

Zahra’s awareness of immunization and family planning is a result of the campaigns carried out under the System Enhancement for Health Action in Transition (SEHAT) Program, which have raised public awareness of health issues in Herat Province. The campaigns are conducted by more than 1,000 health posts across all districts of the province. “The majority of people have acquired an awareness about family planning, contagious and non-contagious diseases, immunization, and protecting the environment,” says Soghra Hashemi, vaccinator at the Jebrael basic health center. “If they fall ill, they immediately visit their nearest health center.”

As one of 85 health centers in Herat Province, Jebrael health center provides basic health services to about 60,000 people and sees an average of 300 visitors a day, most of whom visit the immunization and general outpatient units.  The health center, which is open daily, is located northwest of Herat city.

Due to the increasing population density of the area it serves, Jebrael health center soon will be upgraded to a comprehensive health center. This will allow the center to expand health care services, offer 24-hour comprehensive health care services, and meet the large majority of patient needs.

Work closely with community

Health services at the Jebrael health center are provided by Bakhtar Development Network (BDN), a non-governmental organization (NGO), contracted under the SEHAT Program by the Ministry of Public Health (MoPH). The contract is one of several performance-based partnership agreements between MoPH and NGOs, which deliver a defined package of basic health services and essential hospital services. The provision of services by NGOs are monitored through the regular health management information system, and through facility and community assessment carried out by a third party.

SEHAT aims to expand the scope, quality, and coverage of health services provided to the population, particularly for the poor. It supports the provision and improvement of a basic package of health services and an essential package of hospital services to the entire country. It is supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors.

BDN provides basic health services in the 85 health centers across Herat Province under a three-year program costing 937 million afghanis (about $13.5 million). “One of the significant outcomes of SEHAT in Herat Province is the trust we have won,” says Azizurrahman Saboor, BDN’s technical manager for the SEHAT Program in Herat Province. “We work closely with the communities, which has facilitated people’s greater access to health care services.”


Image

The program has also established a Healthy Mothers’ Association, where women share their experiences and midwives respond to questions and concerns from pregnant women.

Rumi Consultancy / World Bank

" We work closely with the communities, which has facilitated people’s greater access to health care services.  "

Azizurrahman Saboor

Technical manager for SEHAT Program, Bakhtar Development Network (BDN)

Image

SEHAT has built maternity waiting rooms in Koskhk, Rabat-e-Sangi, Adraskan and Golran districts to allow women who travel from remote areas to arrive at the health care center before delivery and stay until postnatal recovery.

Photo Credit: Rumi Consultancy / World Bank

Program builds capacity

With support from the SEHAT Program, BDN has hired nightshift midwives in six Herat health centers, which means that children can be delivered safely by trained midwives at any hour. One of the centers is the Nawabad Health Center, which has seen more than double the number of childbirths since the initiative was introduced.

In addition, SEHAT has built maternity waiting rooms in Koskhk, Rabat-e-Sangi, Adraskan and Golran districts to allow women who travel from remote areas to arrive at the health care center before delivery and stay until postnatal recovery.

The program has also established a Healthy Mothers’ Association, where women share their experiences and midwives respond to questions and concerns from pregnant women.

SEHAT is building capacity in the province by establishing a midwifery and nursing school. There are currently 24 students studying midwifery and another 24 completing professional skills training in their respective nursing fields. Upon graduation, they will be recruited as professional nurses and midwives to work at health centers across Herat Province.

Other capacity building measures under SEHAT include monthly training by BDN for all health care staff. The training focuses on staff needs in areas such as malnutrition, polio, tuberculosis, and laboratory techniques. “The capacity building training of the SEHAT Program is raising staff awareness and enthusiasm for their work,” says Mohammad Zahir Rezayi, head of the Jebrael basic health center.



Community Health Care Increases Access to Medical Services in Afghanistan
Api
Api