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[ Recorded presentation ] Recorded presentation

Promoting and evaluating equitable access to quality health services: Experience in post-conflict rural Afghanistan

Laurence D. Laumonier-Ickx, MD, San San Min, MD, Paul L. Ickx, MD, MSc, and Abdul Shakoor Hatifie, MD. Management Sciences for Health, REACH/Afghanistan, 784 Memorial Drive, Cambridge, MA 02139, 617-250-9500, llickx@msh.org

The Ministry of Public Health (MOPH) of Afghanistan considers a healthy life the right of every individual and promotes equitable access to quality essential health services as a way of ensuring it. In post-conflict Afghanistan, the scarce still-existing health services are ill-distributed and in precarious condition, which contributes greatly to their low utilization rate. The Basic Package of Health Services (BPHS) for Afghanistan promotes a population-based redistribution of a package of focused health services addressing the main causes of mortality and morbidity. It also allows implementing the MOPH's health strategy through a standard-based quality improvement tool, the Fully Functional Service Delivery Point (FFSDP) at the health facility level. Consensus was reached on a set of 103 standards reflecting the preconditions to deliver the services recommended in the BPHS and covering infrastructure, human resources, management practices, and community involvement. REACH developed an implementation framework in which the results of alternating self-assessments and external evaluations of health facilities are compared to the set standards. Targeted technical assistance focuses on weaknesses discovered in each assessment, often requiring behavioral changes by providers and patients. The use of a transparent standardized assessment tool helped strengthen the supervision of the health service delivery points, facilitated the establishment of a relationship of trust between the provincial MOPH and the NGOs, and promoted ownership of the health services by the rural communities. The impressive quality improvements in service delivery, as well as the consolidation of the partnership between MOPH and NGOs in 13 provinces, led to the decision of the MOPH to adopt the FFSDP as a national quality management tool.

Learning Objectives:

Keywords: Quality Improvement, Performance Measurement

Presenting author's disclosure statement:

Any relevant financial relationships? No

[ Recorded presentation ] Recorded presentation

Improving Quality! Practical Models that Work

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA