Post on 27-Jan-2016
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Mohammad Dauod Khuram MD, MPH
National Manager, Health Program
Aga Khan Foundation, Afghanistan
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Afghanistan Health Status:
Live expectancy at birth:
Male : 44 years
Female : 43 years
Maternal Mortality Ratio: One of the highest in the world (1600 per 100,000 live births)
Infant Mortality Rate: 129 per 1000 live births
Under-five Mortality Rate: 191 per 1000 live births
One of the high prevalent country for communicable and vaccine preventable diseases.
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Hospital-based Services:
There are 112 public hospitals in Afghanistan:
National Hospitals: 17
Regional Hospitals: 7
Provincial Hospitals: 34
District Hospital: 52
Total number of available hospital beds: 9133
Approximately 50% of the available hospital beds are at Kabul
The rest of the country has 0.35 beds per 1000 population
Badakhshan has 0.28 beds per 1000 population
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
National Policies for Health Care services:
In 2003 Afghanistan has adopted a standard package to deliver Primary Health Care and Hospital services
The Essential Package of Hospital Services was introduced by the Ministry of Public Health to:
Standardize hospital structure and service delivery
Improve quality of services and hospital management
Promote equitable distribution of hospitals
The implementation of this standard package was contracted out to Non-Governmental Organization under a partnership-based contract
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Badakhshan:
Population: 574,800
Health Set up:
Provincial Hospital: 1
District Hospitals : 3
Other health facilities: 58
Faizabad Hospital:
No of beds: 100
Type of hospital: Provincial
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Performance-based Partnership between the Ministry of Public Health Afghanistan and the Aga Khan Development Network for delivering Essential Package of Hospital Services at Faizabad Provincial Hospital, Badakhshan
Partnership contract with Roshan mobile company for operating the telemedicine at Faizabad Provincial Hospital
Contract of cooperation with KfW for upgrading the hospital setup at Faizabad Provincial Hospital
Service contract with Norwegian Ministry of Foreign Affairs for construction of MNCH ward at Faizabad Provincial Hospital
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
USAID: Funds the service delivery
Ministry of Public Health: Principle Recipient (Client)
KfW: Rehab/Constraction, equipment and e-health
Aga Khan Development Network: Implementing partner as well as funding partly
Roshan Mobile Company: Supporting telemedicine
Swedish Committee for Afghanistan: Supporting physiotherapy services
Norwegian Ministry of Foreign Affairs: construction & equipment of maternity ward
CHEF: for specialized eye services
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
To deliver a standard package of services
To improve the quality of patient care
To promote a comprehensive referral system with other hospitals
To increase efficiency of hospital operation
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Hospital Board
Hospital Director
Administrator
AKHS(Afg)Country Program Director
Nursing Departments
Central Sterilization Unit
Kitchen
Finance & Accounting
Laundry
Finance Manager Nursing Manager Medical Directors
Cost Sharing
Human Resource
Procurement/ Medical Stores
Facility Management
Operating Theatre
Clinical Services
Medical records/HMIS
Diagnostic Services
Pharmacy
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
The performance of this partnership contract is evaluation based on the following milestones:
Bed Occupancy Rate
Average Legnth of Stay at Hospital
Average Number of Birth Deliveries per Month
Number of Out Patients received Services
Number of In-Patients received Services
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Challenges Mitigation Recruiting and retaining qualified health workers
Various motivating for attracting and retaining qualified staffs are introduced such as capacity building opportunities, baby care taking facilities, annual bonuses and other
Balancing the local needs and available scope of services
The hospital has been connected with FMIC at Kabul and Karachi. New center for excellence will be established that can handle some of the critical cases
Hard geography and difficult communication
Post operative patients from the areas with difficult access (through donkey or hours) are kept for a longer period at the hospital
Ensuring optimal coordination among the actors in the partnership
Regular coordination meetings are organized, joint supervision and monitoring is conducted with the provincial MoPH officials and progress updates are shared timely
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Increased the number of hospital beds from 85 to 100
Improved utilization
Increased the bed occupancy rate to 95%
Increased the number of child birth from the average of 183 to 222 per month
Linked through telemedicine with Kabul, Bamyan and Karachi for:
Staff capacity building through teleconferences
Consultation on complicated cases
Sharing complicated images for result
Build new Maternal, Neonatal and Child ward
Clinical training site for CMEP and CHNP
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Community perception regarding the quality of services is key for optimal utilization of services
Maintaining proper coordination is critical for having good partnership
Staff motivation and acknowledgement of best practices is critical for staff retention and efficient output
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Health Management Information Systems (HMIS)
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
28 – 29 September 2011Vedic Village Spa Resort Kolkata, India.
Thanks