hayat burhani, nadera, md, mph, mppm (fellow, melbourne university) melbourne 7may 2015 can aid be...
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Hayat Burhani, Nadera, MD, MPH, MPPM (Fellow, Melbourne University)
Melbourne
7May 2015
Can Aid be delivered effectively in insecure contexts?
The MoPH, Donors and the NGOs Partnership and its Impact on Maternal and Child Health in Afghanistan
Outline:
Health sector Key information Health system Pyramid strategies for health services BPHS, success and challenges
Total Population (CSO) 27.5 MillionPopulation Growth (AMS ) 2.4%Women of Child Bearing Age(15-49) 5.5million
Literacy Rate (General Population) 29 – 38%Women Literacy Rate 14%
Indicators 2002
Maternal Mortality Ratio 1600Under five Mortality Rate 257Infant mortality rate per 165Life expectancy rate 42Number of midwives 462Coverage of Primary Health Care (1h walk from Health Facilities)
5%
Health Situation in 2002
National objectives
• To reduce maternal and newborn mortality
• To reduce under 5y mortality and improve child health
• To reduce the incidence of communicable diseases
• To prevent and reduce malnutrition
• To develop the health system
The MoPH Strategies for provision of health services and Number of Health facilities per year.
Basic Package of Health Services Supported by donors agencies Implemented by NGOs and SM Essential Package of Hospital Services Supported by Core budget Implemented by the MoPH Tertiary Services
Supported by government budget
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
500
1000
1500
2000
2500
496
1112
1281
1237
1420
1667
1803
1987
2016
2047
2160 2286
Success and Achievements
Increased access from 8% to 57% from 2003 to 2013 Defined all PHC service in a single package and provided opportunity
to holistic implementation Through contract out of service delivery MoPH focused on
stewardship role BPHS is a pro-rural concept and responded to health need of most
essential interventions for mother, child, under-served and hard to reach population
The establishment of 34 Community Midwifery programs, trained, 3334
The establishment of Community Nursing Programs started 2011, 360 graduated and 994 under training
Training of 28837 Community Health Workers
Continue
Indicators 2010 (AMS)
Maternal Mortality Ratio 327Under five Mortality Rate 97Infant mortality rate per 77Life expectancy rate 64Number of midwives 3334Coverage of Primary Health Care (1h walk from Health Facilities)
57%
Key National Indicators in 2010
Improve the quality of health service at all levels with intention to improve the health outcomes
Expansion of service to marginalized population (left out from BPHS, Nomades, IDPs, and highly mobile population)
Enhance the health services to under-served components of the package (mental health, disability, essential drugs)
Financial and programmatic sustainability of services in long term and defining an exit strategy for BPHS
Having special package to security compromised area in Afghanistan
Challenges