Agency : Mobile health team, Health System Effectiveness, BPHS Frame, Afganistan Health Services
Objective : To evaluate the effectiveness of the Mobile Health Teams (MHT) considering Afghanistan’s geography and consequently to bring changes into the BPHS frame
Background : Years of insurgence has devastated the health system of the country leaving people in misery and poor health. After the decades of war in 2002, Afghanistan launched Basic Package of Health Services (BPHS) program to deliver Primary Health Care services. From the Annual Health Survey 2006, it was found that only 66 percent of the population could access the health facility. To increase the coverage of health services mobile package of health services was implemented in 2008 to reach the remote areas residing in small pockets of the mountainous topography of the country which are hard to access.
Methodology : Across sectional study was conducted in 11 provinces of Afghanistan which were purposively selected. The study involves both qualitative and quantitative data collected through in-depth interviews, FGDs and exit interviews from community, health providers, implementing organization and key informants.
Findings : The participants of the study were satisfied with the implementation of MHT program and wanted to extend this program to all over the country with few changes in the implementation and management aspects of the program. The major weakness of the program was implementing organization and the MHT staff was the feeble monitoring system. Shortage of female staff, medical equipments and drugs, low salary of the staff, inefficient vehicle were other issues that stemmed up in the discussion. Though clients were very happy and satisfied with the MHT program and the staff but suggested to improve the quality of the drugs and recruit more female staff in the structure. Community was cooperative but very less has been done to strengthen the Community Based Health Care objective of the program. Interestingly, it was found that more female clients approached MHT for treatment and for seeking preventive services which was due to the presence of female staff in the team. MHT has also played an important role in detecting TB cases and controlling other communicable diseases especially in children. Their vital role in providing quick services at the time of disease outbreaks and natural calamities was also emphasized. Overall MHTs are found to be effective in providing healthcare services to the millions of people in dire need.
Recommendations : The ministry has recommended to strengthen the monitoring system, providing regular trainings to the MHT staff and other stakeholders, increase community participation and focus more on CBHC, strengthen the coordination among the various stakeholders in the programs. The study will help the government to take further decisions on whether to sustain the program, to end it or to mould it, to make it more effective and a successful endeavor.
To evaluate the effectiveness of the Mobile Health Teams (MHT) considering Afghanistan’s geography