Monitoring and Evaluation: Technical Assistance for Strengthening Health of the Rural Poor (METASHARP)

Agency : MoPH, Afghanistan

METASHARP project was a contract between the Ministry of Public Health (MOPH), Islamic Republic of Afghanistan and the Johns Hopkins School of Public Health (JHSPH), USA. IIHMR provided technical support to the Provincial Health Offices and MOPH to enable them to play a greater role in data analysis and monitoring and evaluation activities under National Health Services Performance Assessment (NHSPA) of all types of health facilities in Afghanistan.The first round of NHSPAstarted in 2004 andwas completed in 2009- 10.

The Ministry of Public Health (MoPH) of the Islamic Republic of Afghanistan, with technical assistance from the Johns Hopkins University Bloomberg School of Public Health (JHSPH) and the Indian Institute of Health Management Research (IIHMR), has used the Balanced Scorecard (BSC) to measure the performance of Afghanistan’s provinces in the delivery of the Basic Package of Health Services (BPHS), and to provide policymakers, health managers and the public with evidence concerning areas of strength and weakness. The BSC was used by the MoPH to clarify its vision and strategies, and to manage change through a set of indicators that reflected the policies and strategies of the MoPH.

The BPHS BSCwas revised substantially in 2011 to reflect the changing policies and conditions in the country. The 2012-13 BSCwas based on the data collected from 725 randomly selected BPHS health facilities in 34 provinces across the country, and involved observations of 6,930 patient-provider interactions and patient exit interviews, along with 2,403 healthworker interviews. The indicators and methods used for estimation in 2012-13 BSCwere the same as those used in 2011-12 BSC.

The revision was carried out through a participatory process that was led by the MoPH and with active involvement of various other stakeholders in the Afghan health sector including the non-governmental organization (NGO) implementing partners, donors, health worker association representatives, and other stakeholders, including a MoPH led BSC Technical Working Group. The Third Party Evaluation team from the Johns Hopkins Bloomberg School of Public Health (JHSPH) and Indian Institute of Health Management Research (IIHMR) facilitated the process.



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