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.”