Technical Cooperation Programme to the Ministry of Public Health

Country: 
Afghanistan
Region: 
Area of competence: 
Health Policy and Financing
Donor organization: 
EU (European Union)
Start of Project: 
04/2012
End of Project: 
03/2016
Staff-month: 
228
Value of service: 
€ 6,203,173
Partner Organisations: 
AEDES
Description of Project: 

Afghanistan has some of the poorest health indicators in the world. Priorities for rebuilding the national health system are expanding health services through Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS), and institutional development. Health services have been provided as an integrated package in the BPHS and EPHS facilities, delivered in part through contracts to NGOs overseen by the Ministry of Public Health (MoPH). As indicated in the MoPH Strategic Plan (2011-2015), despite the achievements of the past 10 years, Afghanistan was still facing a number of challenges related to the health of its people.
The MoPH has grown considerably stronger since its reform. Progress has been facilitated by a number of civil service reforms instituted by the Government of Afghanistan. Donor funds were used to finance all of the major programs of the MoPH, including the delivery of the BPHS, EPHS, Programs aimed at controlling malaria, TB, Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) and other communicable diseases. EU, USAID, World Bank and other partners of the health sector support vertical programs that were not yet fully integrated into the BPHS and EPHS. In addition, they also provided Technical Assistance through separate contracts to various departments to develop the capacity of the MoPH to strengthen its stewardship role in the management of the health sector. This single contract was supposed to build on the achievements and success that had been made so far and to ensure the continuation of the EU support to the MoPH at central and provincial levels, as well as reduce the transaction cost and improve efficiency.

Description of Services: 

Key objective was to strengthen the capacity of the MoPH to steer and manage health services and the public health system including financial, human and physical resources by providing Technical Assistance to enable units to develop sound policies, strategies and operational plans and oversee their implementation. Among others, the following results were achieved:
Component 1: Support to Aid Coordination and Sector Wide Approach

  • Established Aid Coordination Unit;
  • Developed Sector Wide Approach manual as well as Provider Payment Roadmap;
  • Established and implemented Technical Assistance Management Tool (TAMT).

Component 2: System Enhancement of Health Action in Transition (SEHAT) Procurement and M&E:

  • Procurement of the SEHAT NGO contracting process with the evaluation of BPHS and EPHS proposals for 18 provinces;
  • Strengthened Capacity of procurement staff.

Component 3: Human Resources Management

  • Assisted in rebuilding the Human Resources Management Information System;
  • Developed Standard Operating Procedures for the General Directorate HR;
  • Conducted training in Dewdney provincial workforce planning and community health facility workload analysis;
  • Drafted President’s Human Capital Council Workforce Plan for the health sector;
  • Supported establishment of Interim Medical Council;
  • Trained MoPH/MoE trainers in accreditation systems for institutions, curricula and trainers.

Component 4: Provincial Capacity and Coordination

  • Finalised decentralisation strategy and implementation plan;
  • Developed planning and reporting guidelines as well as provincial budgeting guidelines.

Component 5: Health Promotion

  • Trained Health Promotion Department staff in health promotion technical skills;
  • Trained staff to plan, implement and evaluate a plastic bags campaign and mentored in the implementation;
  • Developed plans for a healthy districts project as well as 3 health promoting hospital projects.

Component 6: Disability and Rehabilitation

  • Integrated Disability and rehabilitation service package into BPHS;
  • Completed guidelines for service provision and staff training package;
  • Conducted training on spinal cord injuries and cerebral palsy;
  • Conducted assessment of disability and rehabilitation hospital and developed implementation plan;
  • Upgraded physiotherapy curriculum and National Disability and Rehabilitation Strategy;
  • Trained service providers in 9 provinces on UNCRD.

Component 7: Mental Health

  • Revised National Mental Health Strategy, upgraded Mental Health legislation and developed Code of Practice;
  • Adapted mhGAP guidelines and trained doctors in 3 provinces;
  • Revised Mental Health hospital guidelines and procedures;
  • Developed Mental Health M&E system as well as clinical supervision checklists;
  • Drafted Suicide Prevention Strategy.

Component 8: Prison Health

  • Revised and updated prison health services strategy and package;
  • Prepared Code of Conduct for release on humanitarian grounds;
  • Provided support for the establishment of fixed prison health facilities in 10 provincial prisons;
  • Established health commission responsible for the evaluation of health of sick prisoners.
Project Volume: 
€ 8,861,677