Health Policy Project

The Health Policy Project has ended, but work continues under a new USAID five-year project, Health Policy Plus (HP+).


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Public-Private Partnership Hospitals to Bring High-Quality Health Services to More Afghans

Sheik Zayed Women’s and Children’s Hospital Photo Credit: Afghan Ministry of Public Health

Posted October 15, 2014

In October 2014, the Afghan Ministry of Public Health (MoPH) issued the first request for private companies to take on the operation of three of the country’s donor-built hospitals. Referred to as public-private partnerships (PPP), these agreements allow private sector companies to provide services (such as healthcare) that are traditionally provided by the public sector (i.e., government). The MoPH will issue a request for qualification (RFQ) that will begin a bidding process among private companies to operate the first of three hospitals, the Sheik Zayed Women’s and Children’s Hospital; RFQs for Jinnah and Jamhoriat General Hospitals will follow within 4–6 months. The Sheik Zayed RFQ will constitute the first large-scale hospital public-private partnership in Afghanistan under the new framework, with all three potential PPP hospitals adding almost 500 much-needed beds to the country’s healthcare system.

As an obligation of the PPP, hospital operators responding to the RFQ will be required to meet international quality of care standards within five years. At present, there are no internationally accredited hospitals in Afghanistan, leading many Afghans to seek care (and spend an estimated US$285 million annually) in neighboring countries, such as India and Pakistan.  The quality of care contracting component within the PPP hospital agreements, coupled with recent enhancements to the ministry’s ability to measure baseline quality under the Minimum Required Standards, will empower the government to ensure greater safety and higher quality care for the population. With an increased availability of care at the new PPP hospitals and the ability to measure the quality of services, the MoPH and the private sector will be better equipped to provide Afghans with high-quality local care options.

The MoPH, with support from Futures Group under its USAID-funded Health Policy Project (HPP), has worked over the past two years to lay the foundation for these partnerships by developing a new PPP policy framework for the use in the country’s health sector. The framework provides the Afghan government with a transparent, public process to market PPP opportunities to foreign and domestic investors and to encourage participation in Afghanistan’s expanding economy. Beginning in 2012, the MoPH Directorate of Private Sector Coordination (DPSC) established the Public-Private Dialogue Forum, engaging key private sector entities and MoPH staff to discuss private health sector concerns and review policies and regulations affecting the private health sector and potential PPPs. Held quarterly, the forum continues to offer private health sector leaders an opportunity to meet face-to-face with the Minister of Public Health, Dr. Suraya Dalil, and ensures the public and private sectors evolve together to create sustainable partnerships for care.

HPP provided technical support to the MoPH through the many stages of readying hospitals for RFQs and establishing PPPs. The HPP/Afghanistan team has supported the MoPH’s engagement with the global private health care sector at unprecedented levels including conducting detailed investor research and organizing market sounding events and investment promotion conferences. Khan Mohammad Zamani, head of the MoPH PPP Unit, said, “Just a few years ago, the promotion of private investment in health by the MoPH wouldn’t have happened. But now we have the systems in place to work in partnership with the private sector through PPPs to bring high-quality health services to more Afghans. These actions have generated a lot of interest from private investors in global markets, and we are ready for the next phase—which is to secure PPP contracts for all of these facilities.”

Under the guidance of the MoPH, DPSC, and the PPP Unit, and in collaboration with several government ministries, Futures Group, through HPP, is continuing its PPP work in Afghanistan. The project is currently working with partners to complete a PPP manual, propose a modification in the procurement laws to accommodate PPP activities, continually update the MoPH PPP web presence, and explore packages of investment incentives. 

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The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. The project's HIV-related activities are supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). It is implemented by Futures Group, in collaboration with Plan International USA, Avenir Health (previously Futures Institute), Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and White Ribbon Alliance for Safe Motherhood (WRA). The information provided on this Web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

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