Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111339

Omid Ameli, MD, Rural Expansion of Afghanistan’s Community-Based Health Care Program (REACH), Management Sciences for Health, 784 Memorial Drive, Cambridge, MA 02139, 617.250.9500, oameli@msh.org, Paul Ickx, MD, MPH, Rural Expansion of Afghanistan's Community-based Health Care (REACH), Management Sciences for Heath, 784 Memorial Drive, Cambridge, MA 02139, and Sallie Craig Huber, MPH, Rural Expansion of Afghanistan's Community-based Health Care (REACH), Management Sciences for Health, 784 Memorial Drive, Cambridge, MA 02139.

Performance based grants between the Ministry of Public Health (MOPH) and NGOs to deliver community-based primary health services is the main strategy for rapid expansion of access to health services for millions of Afghans. Through funding from USAID, Management Sciences for Health (MSH) is providing technical assistance to implement this strategy and monitor its progress.

Based on the findings of a nationwide survey of health facilities, 64 districts in 14 provinces were identified for support from USAID. Twenty NGOs received service delivery grants which hold them accountable for achieving agreed upon results. Process indicators are monitored routinely through reports from the Health Management Information System of the MOPH. In addition, each NGO grantee reports on progress against ten key population-based public health indicators reflecting the status of mother and child health at the beginning of the grant, at midterm, and at the end of the project.

The inhospitable terrain, the limited timeframe, and the decentralized implementation mode of this program prompted MSH to introduce Lot Quality Assurance Sampling (LQAS) to allow the NGOs to undertake rapid and statistically valid assessments of performance in each implementation area. This novel approach for Afghanistan allowed all NGOs to obtain valid baseline values and to set realistic targets for the agreed upon health indicators. It also allowed quick mid-term evaluation of progress in underachieving areas, without overburdening service delivery staff. The MOPH is introducing the LQAS method at the provincial level to identify areas of greatest need in each province.

Learning Objectives: At the conclusion of this session, the participant will be able to

(
• Explain the advantages of using the LQAS survey methodology in challenging settings such as Afghanistan’s public health program. (
• Introduce the LQAS at the project implementation level in settings where this methodology has not ever been tested or used before. (
• Consider application of this methodology to encourage project and facility managers to use epidemiological information to focus local health programs in addressing key public health challenges.

Keywords: Data Collection, Survey

Related Web page: www.msh.org/afghanistan/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.