The Health Policy Project has ended, but work continues under a new USAID five-year project, Health Policy Plus (HP+).
Author(s): Aaron Blaakman and Aung Lwin
Primary Language: English
One of the key innovations in the reconstruction of Afghanistan's health care system since 2001 is the design of the health service delivery structure, including the Basic Package of Health Services (BPHS). The Ministry of Public Health (MoPH) manages, finances, and provides the BPHS through two service delivery mechanisms: contracting-out to nongovernmental organizations (NGOs) and through the MoPH Strengthening Mechanism (SM) model (contracting-in). Despite the MoPH's oversight, governance and stewardship over both delivery mechanisms, inevitably there are differences (as well as shared experiences) between the two contracting modalities. Although there are a few studies comparing these modalities, important poilcy and implementation questions remain, including: (1) Are there differences in BPHS indicators (effectiveness and relative cost-efficiency) achieved under the two models? (2) Are there differences in the relative cost and quality of BPHS services delivered under these two models? (3) Is there a correlation between contracting mechanisms and equity in service utilization among income quintiles of Afghanistan households? To address these questions, this study investigates important issues related to cost, quality and equity of BPHS services under the two contracting modalities.