Quality care and health campaigns boost Afghan communities’ well-being
By Delice Gan and Raouf Zia
A short clip about vaccinations is playing on the TV of the waiting hall. All eyes are locked on the screen. A young girl talks about the importance of vaccination in early childhood. She directly encourages people to bring their children to the nearest health center for vaccination.
Alif Khan, 60, is sitting in the tiny waiting hall of the Dargai Comprehensive Health Center (CHC) for a routine vaccination visit. Next to him is his grandson, 4, whom Alif Khan has brought for a vaccination. They are not alone in the hall, a group of more than 20 people are also there, watching the health awareness clips and making small talk.
Alif Khan lives in Potkai Lalmi village in Tanai district, Khost Province, in southeast Afghanistan. Eight years ago, people of the district were very conservative when it came to health matters. Alif Khan remembers the time when his brother died of appendicitis because they didn’t take him to a health center. “In the past, when a person had an illness in the village, people thought it was infectious and denied treating them normally,” he says. “It was hard, especially for those who had tuberculosis, because people used to believe that it did not have a cure.”
Today, residents in Tanai district are more informed about health matters. Dargai CHC holds public health awareness campaigns regularly, carried out by 24 Community Health Workers (CHW). In addition to the campaigns, doctors in the health center engage in public awareness. The TV in the waiting hall is another source of information. “We are very lucky that our doctors have a good understanding of our culture and traditions. They understand us well and deliver the services efficiently,” remarks Alif Khan as he prepares to take his grandson into the vaccination department.
“Now there is not a single woman in our village who hasn’t come to the health center and we are really happy with the services at the Dargai Health Center.”
Almarah, resident, Tanai district
Dargai CHC is one of 30 health centers in Khost Province that deliver a Basic Package of Health Services under the System Enhancement for Health Action in Transition (SEHAT) Program, implemented by the Ministry of Public Health (MoPH).
The clinic was established more than 20 years ago, as a small health center. Today, it has upgraded to a CHC with 21 employees, including doctors, midwives, nurses, and other support staff, serve 25,000 people in Tanai district. It receives 150 patients per day on average. “People walk long distances to reach the health center, because they trust us now” says Dr. Pacha Khan, 50, who has worked in the center for more than 20 years. “Their well-being is improving day by day.”
SEHAT aims to expand the scope, quality, and coverage of health services provided to the population, particularly for the poor. It is supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors.
Health services at the CHC is provided by the Organization for Health Promotion and Management (OHPM), a nongovernmental organization (NGO), which has been contracted by MoPH. The contract is one of several performance-based partnership agreements between MoPH and NGOs to deliver defined packages of basic health services and essential hospital services under the SEHAT Program.
Reducing Maternal and Child Mortality
OHPM started implementing the SEHAT Program in Khost Province in July 2015 and will continue until June 2018. SEHAT covers more than 565,000 people in the province. It works to deliver all types of health services, focusing on reducing maternal and child mortality across the province.
Toward this end, the midwifery service has been strengthened in the province. According to MoPH regulation, each CHC should have two midwives, but in Khost OHPM has hired four midwives in each of the five CHCs. “We have good coordination in the SEHAT Program internally and with other organizations, especially with a French NGO, Doctors without Borders (MSF),” says Dr. Abdul Wali, SEHAT Project Manager in Khost Province. “Through this coordination, we have hired 20 more midwives in our five CHCs.”
This initiative has improved delivery of health services for mothers and children as well as raised awareness of the services. Midwife Nooriya Rahmani, who has worked in Dargai CHC for more than five years, affirms that “a few years ago, women used not to come to the health center as their knowledge about health services was very low.” But now, she says, people come seeking the services. “It shows that awareness has been raised among people in the district.”
The gynecology department of Dargai CHC receives an average of 50 patients per day and carries out three to four deliveries per 24 hours. The midwives also give health education to the women who come to the center, which has helped them to know about different illnesses. “Now there is not a single woman in our village who hasn’t come to the health center and we are really happy with the services at the Dargai Health Center,” says Almarah, 40, a resident of Tanai district.
