Afghanistan

Strengthening Pharmaceutical Systems (SPS) Program

2007–2012

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Strengthening Pharmaceutical Systems is a follow-on to the Rational Pharmaceutical Management (RPM) Plus Program. MSH is pleased to announce that the US Agency for International Development has awarded us the Strengthening Pharmaceutical Systems (SPS) Leader with Associates Cooperative Agreement. SPS will focus on four key results:

• Improve governance in the pharmaceutical sector
• Strengthen pharmaceutical management systems to support public health services
• Contain the emergence and spread of antimicrobial resistance
• Expand access to and improved use of essential medicines

The five-year, $147.5 million cooperative agreement is led by Dr. Douglas Keene as Program Director, Dr. Sameh Saleeb and Dr. Francis Aboagye-Nyame as Deputy Directors. To help meet goals relating to the key result areas, the SPS Program is building on the successes of RPM Plus while expanding the range of technical areas to include financing, pharmacovigilance, pharmaceutical care, integration of new health technologies, and increased use of the private sector, among others. MSH will accomplish this enhanced program of activities by collaborating with a number of new partner organizations. The SPS core partner team includes:

• BroadReach Healthcare
• Ecumenical Pharmaceutical Network
• The Lewin Group
• LMI Government Consulting
• University of Washington Department of Global Health
• WHO Collaborating Center in Pharmaceutical Policy: Harvard University/Boston University

In addition to the core team, MSH is joined by a select group of organizations that will serve as specialized resources for SPS. These organizations include:

• African Medical and Research Foundation
• American Society of Health-System Pharmacists
• Euro Health Group
• Infectious Disease Institute at Makerere University
• Joint Commission International
• London School of Hygiene and Tropical Medicine

As we work toward the overall goal of SPS, the SPS team is striving to advance the science and "art" of strengthening pharmaceutical management systems. The SPS Program provides a great opportunity for MSH and USAID to continue supporting developing countries in their quest to increase access to essential medicines and facilitate the scale up of vital treatment programs.

Technical Support to the Central and Provincial Ministry of Public Health (Tech-Serve) Project

2006–2010

Tech-Serve works with the Ministry of Public Health (MOPH) at the central and provincial level to build its capacity to perform its primary function of guiding the health system by establishing national health objectives that address national health priorities while ensuring equity and fostering sustainability. Tech-Serve provides ongoing technical assistance in key public health technical areas and engages both central and provincial managers in developing their management and leadership skills to focus on health results and accountability. The Tech-Serve Management support for Provinces (MSP) initiative works directly with provincial health directors and their teams to effectively articulate their health priorities, strategies to address health needs, to plan, implement the strategies an to monitor their activities. This project was launched in July 2006 by Management Sciences for Health under an Associate Cooperative Agreement.

Afghanistan COMPRI-A

2006–2010

The Communication for Behavior Change: Expanding Access to Private Sector Health Products and Services in Afghanistan (COMPRI-A) Project is working to increase Afghans’ access to health information and products by strengthening private-sector capacity through a comprehensive and integrated social marketing program. MSH, as subcontractor to The Futures Group LLC, leads the training and policy components of the project.

Specifically, MSH provides the senior team member in Training and Communications for Community Mobilization. This team member will reach many cadres in Afghanistan (mullahs, community shuras, and the general public) with relevant health messages; provide refresher training to community health workers and pharmacists; and equip retailers with interpersonal communication skills about the correct use of socially marketed products. MSH also provides the senior team member in Policy Development and Implementation/Research who will focus on pharmaceutical regulation and policy; Ministry of Public Health policies, standards, and guidelines related to quality of care; building public/private partnerships; and coordinating policy activities among the implementing partners.

Expanding Contraceptive Use (ECU) Project

2006–2008

The previous Accelerating Contraceptive Use (ACU) Project increased contraceptive prevalence rates (CPR) in three areas from 9 to 34; 20 to 44; and 24 to 51 from October 2005 to June 2006. The project demonstrated that innovative family planning approaches can be highly effective in Afghanistan.

With continued generous support from the William and Flora Hewlett Foundation, the ECU project builds on and replicates the model created during the successful ACU project in order to increase access and successful use of contraceptive methods while bringing innovations to meet the needs of women and men in three Afghan communities. The ECU continues working with the same local NGO partners which collaborated with the ACU project (AADA, BDN, and STEP). Also, the project is implemented in close coordination and cooperation with the Ministry of Public Health, the USAID-funded COMPRI-A, HSSP, and Tech Serve projects, local communities, non-governmental organizations, and international organizations.

Rural Expansion of Afghanistan Community-based Healthcare (REACH)

2003–2006

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In May of 2003, USAID awarded MSH a three-year contract to improve access to basic health services for Afghans and to strengthen the national health system. The goal of the REACH Program is to improve the health of women of reproductive age and children under five. REACH is ensuring that an estimated 7.5 million people in underserved areas of Afghanistan have access to a basic package of health services. REACH is strengthening the existing national health system by assisting with the development of policies and standards, building systems for human resources and health information, training nearly 7,000 health service providers including more than 6,000 community health workers and empowering women and communities to protect their health through training and education.

By working closely with counterparts in Afghanistan and the international community, REACH is addressing immediate needs while ensuring rapid start-up activities are consistent with long-term development objectives. 

Accelerating Contraceptive Use Project

2002–2006

Funding from the William and Flora Hewlett Foundation focused on identifying best practices for improving the quality and impact of family planning services in Afghanistan. The intervention began as a small project focused on providing misoprostal tablets to Afghan women in order to prevent postpartum hemorrhaging and therefore decrease maternal mortality.

The project team quickly discovered that, contrary to earlier research and beliefs, there was also a sizable demand for family planning services. By refocusing the funding on understanding the demand for family planning in Afghanistan, the team realized that there was a larger opportunity to improve women’s health and prevent maternal deaths. The MSH project team refocused the grants funding to provide evidence of family planning demands throughout the country to increase its use in the Ministry of Public Health’s Basic Package of Health Services.

Afghanistan Health Services Enhancement Project (AHSEP)

2002–2003

In 2002, the Ministry of Public Health asked MSH to assist in the reconstruction of the Afghanistan health system by heading the first nationwide assessment of health resources in more than ten years. MSH trained teams of Afghan nationals to inventory health facilities nationwide — reaching more than 1,000 facilities, almost 1,500 pharmacies, and interviewing close to 3,000 workers. The survey revealed districts that had only one health facility for every 5,000 people, and some facilities that tried to serve more than 100,000 people. The survey also showed that only half of more than 750 primary care facilities had safe water and only a quarter had electricity, while one-third functioned without toilets. In addition, 40 percent of facilities had no female workers, and strong social barriers often prevented women from receiving health services from men. MSH concluded that 70 percent of primary care clinics were unable to provide complete maternal and child health services. The outcome of this assessment led to the development of the Basic Package of Health Services (BPHS) through a collaborative process involving a variety of stakeholders. The Ministry of Public Health and the donor community are currently using these estimates to provide services through grants to Afghan and international NGOs. The BPHS is now the official policy of the Islamic Republic of Afghanistan, and those delivering government-supported health services must provide the basic package first before adding other services.

Afghanistan National Health Program

1973–1979

Launching a health sector project in Afghanistan in 1973, MSH's founding staff members concentrated on developing a rural health system. MSH founder Dr. Ron O'Connor believed, "given host-country commitment, progress can be made—even in the most difficult environment—in the practical delivery of rural health services in a developing country." After conducting a needs assessment, MSH worked closely with the Central Ministry, both to establish community-based health services for rural populations and to improve the overall delivery of health care in the Afghanistan.