Practicum Summary:

The Role of Health Committees in Strengthening the Peripheral Health System in Takhar, Afghanistan

Nazir Rasuli’s research reviews current practices in the healthcare system at the peripheral level as well as compliance with the Ministry of Public Health, Community Based Health Care policy and health committee guidelines. Due to Afghanistan’s ranking 173 out of 178 on the United Nations Human Development Index, the Basic Package of Health Services for primary health care and the Essential Package of Health Services were created as strategies for community based health care for secondary and tertiary levels of Primary Health Care in 2002. Since the defeat of the Taliban in 2001, medical services in Afghanistan have primarily been provided by NGOs contracted through the Ministry of Public Health. A decade ago, only 9 percent of Afghanistan’s population of 28 million people had basic health coverage; today, nearly 85 percent of the population has access to basic health care within a 2 hour walk. In order to conduct his research, Rasuli conducted interviews and focus group discussions with leading health workers, health shora members in 4 health facilities who serve as the committee and council, and the public health directorate. The specific issues Rasuli addresses in his research is the deficit in managerial and technical capacity of the health council’s members in monitoring the health facility and strengthening the health system, and the low awareness of health council members about their relevant roles and responsibilities in the national community based health care program. Ultimately, Rasuli concludes that providing training for health shoras on conducting and managing meetings, creating capacity building programs by NGOs, increasing interactions between the community and the health facility, and updating heath shoras on current staffing conditions should be included in a comprehensive strategy to improve the overall effectiveness of the health shora and overall Community Based Health initiative.