Partnership Contract for Health in Baghlan

Date: 2 Apr 2017

Introduction

The project has been implemented by Bakhtar Development Network (BDN) in Baghlan province through 51 HFs (Prison Health Clinic 1, HSCs 17, BHCs 20, CHCs 11, DHs 2 and 544 HPs) to serve 769300 populations for a period of PCH project.

BDN offered all components of BPHS through 2 DHs, 1 CHC+, 10 CHCs, 20 BHCs, and 17 SCs , 1 Prison Health Center and 544 HP in the province. These services offered at 6 standard types of HFs, ranging from outpatient care at Sub Centers (SC) and Basic Health Centers (BHCs), to outpatient and inpatient services at Comprehensive Health Centers (CHCs) and DHs. Although, DHs are not supported through PCH project in Baghlan in the first year of PCH project but functionality were maintained and supported through PCH in the last four and half years of PCH project Based on Mou signed with Italian Cooperation / PPHO and MoPH/GCMU/PCH and all activities carried out by BDN till end of Project, meanwhile, MoU signed between Aga Khan Development Network (AKDN) and other active partners to ensure the coordinated service delivery and referral system in there catchment area.

In addition, BDN had the honor of being implementer for the BPHS service delivery through 8 sub centers and 1 mobile health team funded as part of the GAVI project funded by MOPH till end of December 2011, which was handed over to SM/MoPH/PPHD.  In January 2014 the responsibility of mentioned SHCs is handed over to BDN and supported through PCH project till end project June 2015. Given these facts, BDN was perfectly in a better position to coordinate BPHS service delivery at all levels.

Objectives

The general objective of this project was to enhance and improve accessibility of project coverage population to quality health care services in line with the BPHS (MoPH) strategies and policies.  

 The specific objectives are:

  1. To improve quality of services
  2. Expand access of the coverage population to the primary health care service delivery system
  3. To focus on strategic BPHS interventions and cross cutting issue
  4. To plan and implement cross cutting issues like behavior change communication, capacity development, M&E
  5. To ensure effective management and operation of the project

Executive Summary

The project has been implemented according to BPHS by Bakhtar Development Network (BDN) in Baghlan province through 51 HFs (Prison Health Clinic 1, HSCs 17, BHCs 20, CHCs 11, DHs 2 and 544 HPs) to serve 769300 populations for a period of PCH project.

These services offered at 6 standard types of HFs, ranging from outpatient care at Sub Centers (SC) and Basic Health Centers (BHCs), to outpatient and inpatient services at Comprehensive Health Centers (CHCs) and District Hospitals (DHs). Although, DHs are not supported through PCH project in Baghlan in the first year of PCH project but functionality were maintained and supported through PCH in the last four and half years of PCH project Based on signed MoU with Italian Cooperation / PPHO and MoPH/GCMU/PCH. Meanwhile, the Project, signed MoU with Aga Khan Development Network (AKDN) and other active partners to ensure the coordinated service delivery and referral system in there catchment area.

In addition, BDN had the honor of being implementer for the BPHS service delivery through 8 sub centers and 1 mobile health team funded as part of the GAVI project funded by MOPH till end of December 2011, which was handed over to SM/MoPH/PPHD.  In January 2014 the responsibility of mentioned SHCs is handed over to BDN and supported through PCH project till end project June 2015. Given these facts, BDN was perfectly in a better position to coordinate BPHS service delivery at all levels. Aim of the project was to enhance and improve accessibility of project area population to high quality health care services in line with the BPHS (MoPH) strategies and policies.

The project mad extreme efforts to apply successfully proposed strategies with though there was challenges during the project life cycle.

The strategies were focused to three directions: I. Improve quality of health care services. II. Expand access to the services delivery through community based and outreach approaches. III. Focus on critical interventions & Gender.

In the first approach, which is improve quality of health care services encompasses; 1. Strengthening supervision and monitoring system through quality assurance mechanism, assessment of the quality standards and implementation of corrective actions against identified gaps. 2. Capacity building through Cascading Skills & Knowledge Transfers to the Health workers based on needs assessment/technical competency assessment through different method of training consisting of on the job and class based training for various type of health workers. 3. Use of accurate HMIS and other data for improving quality of services and performance. New available Information technology tools applied for strengthening project management. Maintaining a functional data management and reporting system in accordance with MOPH HMIS requirements was one of the major activities toward improving the quality of healthcare services. The second approach was EXPAND ACCESS TO THE SERVICE DELIVERY Through community based and outreach approaches consisting of: a. CBHC planning using Global Position System (GPS): b. Strengthening the CBHC system to promote health in communities. c. Period and regular outreach activities. The third was; FOCUS ON CRITICAL INTERVENTIONS & GENDER trough special focus on all critical interventions as outlined in the revised BPHS. Given the shocking maternal, infant and child mortality rates, more concentration was on child health and safe motherhood/reproductive health interventions.

The project managed by Project Management team including two Cluster Managers assisted Project Manager in monitoring, supervision. Totally 42 staff recruited in Baghlan Sub office. At central level, the PCH lead Project Director based in Kabul along with its technical were responsible for providing the required technical and managerial support by overseeing the project activities. The project activities and its scope of work were coordinated closely with all stakeholder such as; community members, national and international agencies at province level, MoPH and PPHD. 

Controlling mechanism was maintained thorough of project life cycle.  The tools used for this purpose were: adherence to project work plan and its scope; observation and compliance to the organization policies in regard to operations services for logistic and procurement & supplies; standard operational procedures, policies and tools used in financing and approach for good pharmaceutical management and rational use of drug though strong supply management system established in the project. 

Along with, monitoring and evaluation were applies through diverse dimension and tools. Annual Household Surveys was of theses and applied three times as follow; 2010, 2011, 2013. Catchment Area Annual Census were conducted through health workers of relevant HFs from their catchment areas every year. More importantly, external/external evaluation, monitoring and supervisions were conducted as per plan and need.    

Through the aforementioned inputs the output results shows a positive changes and improvement in the e following indicators relevant to access and quality of the services like: number of HFs raised from 25 to 51 and number of active HP from 464 to 556. Indicators relevant to quality of services reflect significant good achievements such as; number of HFs with properly staffed as required by BPHS raised from 13 to 51 and Number of health workers (DH, CHC, BHC, SC) received NGO provided skills & knowledge transfer courses was 100% achieved. . Moreover, 35 different type of professional trainings were provided for 3073 participant during the project 

The summary of  HMIS reflect that number of Institutional Deliveries, OPD, HPs, First ANC and PNC, Family visits of HPs, Penta3 and TT+ in pregnant women have maintained  its ascending  trend during the project with few fluctuations in TB case detection and CPR had descending trend in 2011 continuing with flat trend  afterwards.

Though, the good achievement of the project the following challenges posed during the implementation; a) shortage of qualified staff, b) geographical constrains, c) turnovers and d) un-availability of surrounding walls and drinking water.

Consequently based on the significant good achievement connected to accessibility and quality of the services it can be concluded that, project achieved it aim through an effective and sufficient implementation. Hence, with deliberation of lessons learned and recommendation, primary health care services as a crucial and vital approach for health promotion of country population should be sustained for the future.  

Copyright © MACEC 2016 All right Resverved.
This is official website of Bakhtar Development Network. BDN is not responsible for the content of other sites with similar names.
Designed & Developed by TechSharks