With community health programmes in large geographical areas in Central
and South Asia, as well as East Africa, and over 200 health facilities including
nine hospitals, the Aga Khan Health Services (AKHS) is
one of the most comprehensive private not-for-profit health care systems
in the developing world. Building on the Ismaili Community's health care
efforts in the first half of the 20th century, AKHS now provides primary
health care and curative medical care in Afghanistan, India, Kenya, Pakistan,
and Tanzania, and provides technical assistance to government in health
service delivery in Kenya, Syria and Tajikistan.
Early childhood lays critical foundations for a person’s entire life – a finding demonstrated not only by the latest advanced research in neuroscience and genetics but by nutrition and child development studies and programme evaluation data, including data from AKDN’s own programmes. Investments in Early Childhood Development (ECD) therefore offer outstanding returns, in both human and financial terms. The following paper explores approaches to ECD and the work of several AKDN agencies in this field. More
Foundation Laying Ceremony for the New Bamyan Provincial Hospital
22 April 2013 - The Foundation Laying Ceremony marking the start of construction of the new Bamyan Provincial Hospital (BPH) was held on 18 April 2013 in Bamyan. The BPH will offer an additional 86 beds for pediatric, obstetric and gynecologic care in a region where women’s access to healthcare has been severely limited
Update on FOCUS and AKDN response to Pakistan Floods
03 September 2010 - Focus Humanitarian Assistance (FOCUS) Pakistan has been actively involved in response and relief efforts following continued rains and massive floods affecting various parts of the country.
National Energy Globe Award for Aga Khan Planning and Building Services in Pakistan
06 June 2010 - The Aga Khan Planning and Building Service’s (AKPBS,P) Water and Sanitation Extension Programme (WASEP) in Pakistan was awarded a national Energy Globe Award during a ceremony marking UN World Environment Day. The award recognises projects that “make careful and economical use of resources and employ alternative energy sources”.
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AKHS is one of three agencies of the Aga Khan Development Network (AKDN) that support activities in the field of health, the others being the Aga Khan Foundation (AKF), and the Aga Khan University (AKU). It works closely with both of these agencies on planning, training, and resource development and with the Aga Khan Education Services and the Aga Khan Planning and Building Services (AKPBS) on the integration of health issues into specific projects.
AKHS is organised into national service companies in Afghanistan, India, Kenya, Pakistan, Syria, Tajikistan, Tanzania, and Uganda. The Social Welfare Department (SWD) located within the Secretariat of the Aga Khan in France, co-ordinates the activities of the service companies through five-year plans, ten-year projections, annual budget submissions, and the provision of technical assistance. They are also linked internationally through network-wide strategies in human resource development, hospital management, nursing development, and primary health care. While strengthening its institutions and the links between them, each health service company also joins government health services and other providers in building effective national health systems.
Programmes designed to reach vulnerable groups
AKHS's community health programmes are designed to reach vulnerable groups in society, especially child-bearing women and young children, with low-cost, proven medical technologies: immunisation, systematic prenatal care, aseptic deliveries, and oral rehydration therapy for diarrhoeal disease. Experience with Public Health Centres within the Aga Khan Development Network has confirmed both the efficacy of primary health care in improving health status, and its cost-effectiveness.
In AKHS's approach to health services, primary health care and prevention are considered as steps towards improved health status that must be linked to the availability of high quality medical care. To complement its work in primary health care, AKHS offers curative services in institutions ranging from dispensaries through health centres to full-service hospitals. At each level of care, the AKHS focus is on providing services that are needed and wanted by the community and on building linkages within the system. It also aims to ensure a quality of care that significantly raises local standards. Quality control in laboratory diagnosis, appropriate documentation in medical records, regular supply of pharmaceuticals and continuing education of nurses and doctors are some of the practices that AKHS emphasises in its approach to institutional development.
AKHS's overall major initiatives currently include:
- Assisting communities to develop, manage, and sustain the health care they need.
- Providing accessible medical care in modern, efficient, and cost-effective facilities.
- Working in partnership with other agencies in the development of communities and the enhancement of their health.
- Educating physicians, nurses, and allied health professionals.
- Conducting research relevant to environments in which AKHS institutions exist.
- Contributing to the development of national and international health policy.
Governance and management
In each country of operation, AKHS registers a National Service Company as a not-for-profit, non-governmental agency. Each company has a Board of Directors, Chairman and directors some or all of whom are appointed by the sponsoring company, Aga Khan Health Services S.A., a not-for-profit organisation registered in Switzerland. Governing bodies and regional, community, and institutional committees are established to facilitate planning, operations, and funding activities of the national service companies. All directors serve as volunteers on an unremunerated basis. Typically, the board of each national service company is made up of eleven directors, of which nine are nationals, including the chairman. Each company board appoints a CEO who is responsible for the planning and management of all of the national service company's operations. The services, facilities, and programmes of the companies are funded through local fees charged for services, community support, international donors, as well as through contributions from His Highness. The Aga Khan Foundation assists the national service companies to seek funding and technical assistance from international and local donor agencies for appropriate development or service delivery initiatives.
Every company has a significant, on-going investment programme to develop both its management systems and the quality of its managerial and support staff. Network-wide, there is a strong emphasis on continuous quality improvement as a core organisational development strategy. This encompasses quality assurance, and preparation for accreditation either with a US-based hospital accreditation programme or the UK-based King's Fund/National Health Service accreditation process. The total quality management methodology was introduced to AKHS in 1992 and remains an important activity. There is significant investment in human resource development at every level of each national service company.
All companies also have a significant, continuous investment programme in computer-based management information systems and electronic communications. They also have a strong internal audit function. Each board has an active audit committee and every company undergoes an annual external audit.
Strategies for financial self-sufficiency
While taking care not to compromise its social mission, AKHS encourages an entrepreneurial approach by national service companies in all of their operations. All AKHS community health programmes and services have strategies to achieve financial self-sufficiency. For poorer communities, this may require a timeframe of 15 years or more, but a strategy is developed for each programme to achieve financial self-sufficiency as soon as the economic status of the community served is likely to permit this.
- there is always a user charge, often complemented by other forms of risk pooling and community financing;
- the user charge is complemented by a welfare programme provision for those unable to afford the (often very small) fee; and
- in appropriate circumstances, cross subsidies are used to support community health activities that are not (yet) breaking even.