Despite increases in security incidents, Afghanistan achieved considerable progress in reducing under-five and maternal mortality. These results were achieved by prioritizing and scaling up high-impact health interventions, using data for decision-making, and making full use of all available capacity including non-governmental organizations (NGOs).
The GFF Partnership Response
The GFF partnership is supporting the Government of Afghanistan to better collaborate with NGOs to deliver services, assess their performance and measure the quality of the services providers. Focus is also placed on reducing fragmentation of external resources by mapping and tracking of off-budget and on-budget resources to complement Basic Package of Health Services (BPHS) and an Essential Package of Hospital Services (EPHS) contracts; adopting innovations to reduce maternal mortality and stunting; and increasing access to quality of services such as family planning. The World Bank is supporting Afghanistan’s efforts through the Sehatmandi project, a $600M investment over three years, which covers 31 provinces with these service packages. The GFF is co-financing this project with a US$35 million grant to increase the utilization and quality of health, nutrition, and family planning services. Other external financiers include Canada,the European Union, and USAID.
Despite security challenges, service providers have succeeded in covering almost all provinces (31 out of 34) under the new performance contracting model. The Ministry of Public Health successfully conducted the first semi-annual performance review and results show that the pay-for-performance approach has improved data use and increased the focus on measuring performance. A third-party entity is verifying the performance of these service providers based on Health Management Information System reports and is assessing the quality of services through the balance score card. Data collection and validation with partners has been completed for the national resource mapping exercise. This exercise is intended to inform the next version of the investment case which is currently being develop with partners, agreeing initial health system and health financing reforms to support costing and prioritization discussions.