HPP Afghanistan article selected as Editor's Choice in the Oxford Health Policy and Planning journal
The article, "Government stewardship of the for-profit private health sector in Afghanistan", written by Palladium's Health Policy Project Afghanistan team, was selected as Editor's Choice.
In the decade following the ousting of the Taliban in 2001–2003, the Afghanistan Ministry of Public Health (MoPH), with help mainly from USAID, the EU and World Bank, established a program to reconstruct and rapidly expand the country's basic health services. They contracted for a series of basic and essential package of health and hospital services (BPHS and EPHS) with non-governmental organizations (NGOs) and Provincial Health Offices while simultaneously building MoPH capacity to manage, monitor and evaluate the contracts (Newbrander et al. 2014). Because of this well-executed program, the country's basic health indicators improved significantly (Afghan Public Health Institute 2011). At the same time, Afghanistan's fragmented and largely unregulated for-profit private sector also grew at a rapid pace, accounting for nearly three-quarters of total health expenditures, but with little if any MoPH oversight. In many countries, the private health market is increasingly viewed as a critical component to expanding health services and achieving government health goals (Hort and Bloom 2013; Forsberg B et al. 2011; Lagomarsino et al. 2009). However, in Afghanistan, the MoPH has only recently begun to focus attention on the for-profit health sector as a contributor to the national policy of ′health for all′ (MoPH 2012b). Concerned by the large proportion of total health services provided by unregulated for-profit entities and resultant lack of quality, the MoPH began in 2008 to progressively adopt a combination of strategies, policies and regulations aimed at harnessing the for-profit health sector. The goal of these efforts was to help realize key government objectives of improving the quality of health care, achieving long-term sustainability and increasing private health investment. To carry out these strategic and policy mandates, the MoPH requested technical assistance from USAID, World Bank, EU and others, and launched an initiative to strengthen its stewardship capacity to oversee the for-profit private sector. In this article, we examine the progress the MoPH has made towards more effective stewardship, consider some of the challenges faced and assess the early impacts on for-profit performance.
To see the full article in the Oxford Health Policy and Planning Journal, please click here. This article was written by Harry Cross, Omarzaman Sayedi, Laili Irani, Lauren Archer, Kathleen Sears, and Suneeta Sharma.