Kabul, Afghanistan, 17 February 2019 – In a signing ceremony held at Afghanistan’s Ministry of Public Health, the Aga Khan Health Services (AKHS) took over management of health care facilities in the Bamyan and Badakhshan provinces on a pay-for-performance basis as part of the “Sehatmandi project”.
Through the Project, AKHS - with support from the Aga Khan Foundation (AKF) - will now manage over 1,015 health posts (within villages), 158 basic and primary health centres, 24 comprehensive health centres (around 10 beds each), five (5) district hospitals (30 beds each), and two (2) ISO-certified provincial hospitals in Faizabad and Bamyan until June 2021.
The project has the objective of increasing the utilisation and quality of health, nutrition and family planning services across 31 provinces. The expansion is based on earlier positive experience of the AKHS, which has managed the Bamyan and Faizabad provincial hospitals, on behalf of the government of Afghanistan since 2004.
“The agreement specifies the staff, equipment, diagnostic services and medications that should be provided by each primary health facilities in the Afghan health system,” said Dr. Massoud Mehrzad, CEO of AKHS Afghanistan. “It also sets the standards for hospitals in the system.”
Under the Sehatmandi project, the new health system will operate under a new pay-for-performance model. The Agency’s success will be measured on the number of antenatal and postnatal care visits, institutional deliveries, family planning, growth monitoring and nutrition counseling for children under the age of 24 months, health consultations for children under the age of five, the number of immunized infants, the number of women of reproductive age who are immunized against tetanus, the number of tuberculosis cases that are successfully treated, and the quantity, as well as quality, of caesarean sections and major surgeries.
“The idea that service providers will be compensated for their work if they meet pre-established benchmarks is a game changer for Afghanistan,” said Dr. Gijs Walraven, AKDN Director of Global Health. “And while these requirements may seem challenging, the Aga Khan Health Services and the Aga Khan Foundation are committed to meeting the targets set by the Sehatmandi project.”
The Sehatmandi project was launched in 2018 in recognition that while significant advances had been made to improve access and the quality of health care in Afghanistan since 2002, progress had been uneven. The World Bank - in partnership with the Afghanistan Ministry of Public Health (MoPH), United States Agency for International Development (USAID) and the European Union - launched the programme of performance-based contracts (also known as a pay-for-performance model). The Sehatmandi project holds service providers accountable for delivering improvements based on established targets.
About the Aga Khan Health Services
When Aga Khan Health Services (AKHS) - with the support of the governments of Afghanistan, Canada and France, and His Highness the Aga Khan through AKDN and AKF - first established itself in Afghanistan in 2003, the Agency’s core mandate was to enhance the quality of both primary and secondary health care services in the difficult to reach provinces of Bamyan, Badakhshan and Baghlan. AKHS also partnered with the Afghan government and its Ministry of Public Health (MoPH) by providing them with technical assistance to help improve health care delivery across the country.
AKHS has also trained community midwives to work in rural areas in Badakhshan, Bamyan and Baghlan where maternal and child health care provisions were most needed. The Agency established the first 24-month Community Midwifery Education Programme in 2004, and has since trained, as well as deployed, 459 midwives across the three provinces. In 2012, AKHS initiated the Community Nursing Education Programme, which has graduated 194 community health nurses who now work across the three provinces.
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The Aga Khan Health Services (AKHS) in Afghanistan is an active partner of the Ministry of Public Health (MoPH) in the implementation of the Basic Package of Health Services and the Essential Package of Hospital Services. Through its activities, AKHS provides basic health and hospital services to a population of more than 1.5 million people in some of Afghanistan's most remote and inaccessible districts in the provinces of Badakhshan, Baghlan, and Bamyan. AKHS is also working with the government of Afghanistan to develop and maintain qualified health human resources in all areas of health care by offering continuous education for doctors, nurses, health professionals and administrators, as well as providing technical advice and support on health policy, nursing standards and midwifery education.
The Aga Khan Development Network (AKDN), which was founded by His Highness the Aga Khan, is a private, international, non-denominational development organisation. It employs over 80,000 people in over 30 countries. AKDN agencies address complex development issues, including the provision of quality healthcare and education services, cultural and economic revitalization, micro-enterprise, entrepreneurship and economic development, the advancement of civil society and the protection of the environment. For more information, please see: www.akdn.org/afghanistan