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Performance based financing of basic health services delivery in Afghanistan : challenges and perspectives

Document type: mthesis
Download file(s): 185296 (545 KB)
Abstract: The contracting strategy of the Basic Package of Health Services (BPHS) has begun in Afghanistan since 2003 in response to the poor performance of health system and donors’ willingness to channel their support through NGOs. This thesis describes the concept of contracting of basic health services in developing countries, how it emerged on the policy agenda and its process. It, also, reviews the effectiveness of contracting basic health-care in developing countries and critically evaluates the contracting experiences in Afghanistan using the following criteria: its effectiveness in terms of access, equity, quality and efficiency of health-care. It concludes with some recommendations to decision makers in Afghanistan. A literature review on contracting of basic health-care in developing countries was done. In addition, the results of 2006 Afghanistan Balanced Scorecard were reviewed. Significant improvements have been achieved in terms of access to BPHS, quality of care, reduction of inequity in health and reduction of infant and under five children mortality rates. However, it is not possible to conclude that contracting is completely accountable for the health outcome accomplished. Other factors may also have played a role in improving health care: the removal of Taliban government, the removal of restrictions on women employment, the return of health workers, the general improvement of the socio-economic situation and a relative peaceful situation. Contracting started in all 34 provinces at the same time, but without comparing to other possible alternatives. As conclusion, this thesis gives recommendations for developing a long term strategic partnership between MoPH & NGOs and creation of an enabling environment for the sustainability of health system. A long term partnership will lead to capacity building, maintaining of infrastructure and medical equipments which ensures the sustainability of the health system. In terms of sustainability, it is better to build the capacity of Afghan organizations, especially the Grant and Contract Management Unit of MoPH to gradually take over the work of international donors and NGOs.
Authors: Arzoie, N.M.
Country: Afghanistan
Category: Research
Department: Development Policy & Practice
Institute: KIT (Royal Tropical Institute)
Keywords: health services
Language: eng
Organization: KIT - Royal Tropical Institute
PAGE: vii,42,xix
Year: 2008
Region: Southwest Asia
Right: © 2008 Arzoie
Subject: Health and Nutrition
Title: Performance based financing of basic health services delivery in Afghanistan : challenges and perspectives
Training: Master of Public Health / International Course in Health Development (ICHD)