Health Sector Project
The project, started in September 2004, aims to help the Ministry of Public Health to implement the Basic Package of Health Services (BPHS) in Parwan, Panjshir, Kapisa and Kabul provinces. In other provinces, the provision of BPHS has been contracted out to both local and international NGOs.
All procurement and financial management follow government procedures. A total of 15 national consultants provide technical support. The project has helped to expand the range and reach of health services and improved the quality of service.
Current Status:
In February 2006, a supplemental grant of US$30 million was approved to increase the project budget to expand provision of basic health services in eight new areas across the country where no clinics have been established and where health services have rarely been provided. The supplemental grant also supports the provision of vaccines for immunization campaigns (polio, measles, and neonatal tetanus).
The project is also financing two research projects on a Safe Water System and Health Care Financing. The Safe Water System is being carried out in Wardakprovince and is testing a variety of approaches for decreasing diarrhea and other water-borne illnesses by early 2007. The user charge and control arms of the Health Care Financing project are examining a few approaches to community health financing and will be completed by May 2007. Findings from these two pilots will guide policy formulation on safe water systems and revenue generation for the health sector in the future.
Voices of Beneficiaries
Dr. Mohammad Najib:
click here to listen why rural Afghans no longer need to travel to Kabul for treatment.
“Kapisa province was at the front line during the time of the fighting with the Taliban, and was badly affected. At that time there was only one hospital in the province called Gulbahar. This hospital only provided simple surgery and many basic health services could be provided. ”
Access to health facilities has been a major problem for rural communities in Kapisa province, a few hours drive north of Kabul. Diarrhea and dysentery are common in the region, especially during the summer months as people don’t have access to clean drinking water and drink directly from the river. TB also used to be fairly common. Less than 15 percent of women visited a health facility during pregnancy and delivery, and most babies were delivered at home with a mother-in-law attending.
There province was one of the most badly affected during the civil war. There was only one functioning hospital in Kapisa - the Gulbahar hospital –which provided basic health services and simple surgery to the people. People often needed to walk for 2 or 3 hours to reach a medical facility. For anything more serious, they had to travel to Kabul or Panjshir province for treatment. This was not only an arduous exercise but also beyond what most rural people could afford.
Now much has improved said Dr Mohammad Najib who heads the new Deh Baba Ali Hospital in Mahmod Raqi, the provincial capital of Kapisa province.
Since the project started in 2004, 2 hospitals, 8 CHC and 13 BHC have been established. The hospitals provide all health facilities - pediatrics, surgery, gynecology etc. Over a hundred men, women and children are attended to every day, and people no longer need to travel to Kabul for treatment. Both hospitals now have two ambulances each; the provincial health department has 3 ambulances which are used to bring emergency cases to hospital. Nine sub centers have been opened to bring health services to remote villages.
Children and expectant mothers are regularly vaccinated. There has been no sign of Tetanus and Polio in the region in the past two years. Women are being encouraged to deliver their babies in clinics. More than half of all pregnant women now visit health facilities during pregnancy and delivery. Some 30 community midwives has been trained to help during pregnancy and delivery. In case of complications, these midwives refer the women to health centers. The health education provided to communities has helped decrease mortality from diarrhea and pneumonia. With ten TB centers now operating in Kapisa the incidence of TB, especially among pregnant women, has decreased significantly.
Still much more needs to be done says Dr. Najib. The medical services provided are still not enough to meet the people’s needs. While many more women now come to clinics for antenatal check ups and delivery, the situation differs widely from village to village, and in some parts of the province their numbers are very low. Continuously creating awareness through village meetings and health workers is necessary to get rural people, especially women, to visit clinics voluntarily.
Voices of Beneficiaries
"Five year ago there were no clinics or hospital nearby and we faced many problems. Now there are more clinics and more doctors to help us. The most common diseases among children are pneumonia and diarrhea. Measles used to be a dangerous disease, but since our children are being vaccinated against it for the past few years, we no longer lose our children to it."
Ghulam Sakhi:
click here to listen how Sakhi’s children are being vaccinated against various diseases.
Ghulam Sakhi from Anbia village has brought his 9 years old son to Deh Baba Ali Hospital in Mahmod Raqi for treatment. Sakhi is himself is suffering from high blood pressure and his son has continuous fever and pneumonia. Sakhi is relieved that he had to walk for only 20 minutes to reach the hospital, unlike earlier when there was no hospital in the area and unwell people had to be taken to Kabul or Charikar.
All of Sakhi’s ten children were delivered at home. His mother had to assist with all the deliveries as there was no clinic or doctor nearby. Now that a health facility is available locally, Sakhi’s children are being vaccinated against various diseases and the number of children dying because of disease has reduced significantly.
Voices of Beneficiaries
"Since these hospitals and clinics have started functioning we get all the health services and don’t need to go to doctors in private clinics."
Torpikai left her village at 09:00 in the morning after doing her chores. She reached the hospital after walking for 20-25 minutes with her two year old son who is suffering from diarrhea.
All of Torpikai’s three children were delivered at home. During the war, and before this hospital came up, she and her family used to go to private doctors for treatment. That had cost them a lot. But, since this hospital is functioning well, the village people just bring their children here, saving much time and money. All her children are vaccinated.
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