Provision of Primary and Secondary Healthcare in Urozgan Province

Health Emergency Response (HER): basic package of health services (BPHS) and essential package of hospital services (EPHS) through 64 health facilities in Uruzgan Province. The project is part of program supported by UNICEF (till end of 2023) with financial assistance of World Bank and Asian Development Bank.

The project development objective (PDO) is to increase the utilization and quality of essential health services. Given the urgent need for health sector financing, the design is focused upon improving the utilization and quality of the existing functioning service delivery model.  The Basic Package of Health Services (BPHS) and the Essential Package of Hospital Services (EPHS) form the backbone of the Ministry of Public Health’s (MoPH) Strategy.

Provision of Primary and Secondary Healthcare in Urozgan Province is managing provision of BPHS at the Primary Health Care facilities, EPHS at the Provincial Hospital and District Hospital, and additional value-added high impact interventions for MNCAH to contribute to improving the health status of people in Urozgan, with a focus on reducing the maternal, new-born, infant and child mortality, reducing the incidence of communicable diseases, and improving child health and nutrition.

The provision of BPHS, EPHS and value add MNCAH interventions improve access to quality healthcare for the general population with special focus on vulnerable groups including women, children, disabled, internally displaced people (IDP), people living with chronic infectious and non-infectious diseases, and other marginalized groups.

Urozgan Province contains about 6 districts, over 508 villages, and approximately 579,684 people based on UN data. The large portion of Uruzgan’s settled population belong to ethnic Pashtuns and ethnic Hazaras. There is also a small population of Kuchi nomads, whose numbers vary with the seasons.

The affected people are faced with poverty, global hunger, ethnic conflict, inequality, gender biases, mismanagement of resources, lack of funding for schools and social services, health disparities, inadequate emergency services, low access to clean drinking water, drug abuse, pollution, HIV/AIDS, tuberculosis and COVID-19 pandemic. The children are specifically faced with infectious diseases, malnutrition, early marriage, adolescent pregnancy, child abuse and neglect, domestic violence and exploitation of labor.

The direct beneficiaries are general population of Urozgan Province; approximately 579,684 people, including 118,835 child bearing age women, 46,375 PLW, 27,825 under one and 104,343 under five children and 31,883 disabled.

Direct beneficiaries are beyond the people who receive healthcare. In addition to the free health services provided by this project, the capacities of the professional staff, support staff, and community elders involved in the process will be built up. The families of the staff and local markets will have economic gain from the new jobs created and purchases.

The pay-for-performance (P4P) indicators are:

  1. Antenatal Visits (ANC), all
  2. Postnatal visits (PNC), all
  3. Institutional Deliveries (normal and assisted deliveries at Hospitals)
  4. Family planning visits for modern methods -CYP
  5. Penta 3 vaccination for children <1 year
  6. TT2+ for women of reproductive age
  7. Smear-positive Tuberculosis cases treated
  8. Nutrition- Growth monitoring <2 years and IYCF counselling for pregnant and lactating women (GMP/IYCF)
  9. Under five children’s morbidities
  10. Cesarean-Sections (CS)
  11. Major Surgeries excluding C- Section

AHDS chosen Standard Based Management and Recognition (SBM-R) as methodology to achieve the expected results.  SBM-R is a practical management approach for improving the performance and quality of health services. It consists of the systematic, consistent and effective utilization of operational performance standards as the basis for the organization and functioning of these services, and the rewarding of compliance with standards through recognition mechanisms. SBM-R follows four basic steps:

  1. Setting standards of performance in an operational way.
  2. Implementing the standards through a streamlined and systematic methodology.
  3. Measuring progress to guide the improvement process toward these standards.
  4. Recognizing the achievement of the standards.

The health facilities are on provincial hospital (PH), 1 district hospital (DH), 9 comprehensive health centers (CHC), 14 basic health center (BHC), 34 sub-health centers (SHC) and 3 mobile health teams (MHT) that are supported by 469 number of health posts (HP).