This paper summarizes the proceedings of the Round Table Meeting on the National Improvement Strategy and Infrastructure for Improving Health Care in Afghanistan, which was held January 10, 2010, in Kabul, Afghanistan. The meeting, along with a debriefing session the following day, was held to assist the Ministry of Public Health (MoPH) improve the quality of health care services in Afghanistan, and is part of the United States Agency for International Development (USAID) Health Care Improvement Project’s (HCI) efforts to support the MoPH in developing a new strategy and infrastructure for health care quality improvement.
The MoPH has made great strides since it began to rebuild the Afghan public health system in 2002. It is particularly proud that it has been able to greatly expand access to services: By January 2010, 57% of the Afghan population had access to an Essential Package of Hospital Services (EPHS), and 85% had access to the Basic Package of Health Services (BPHS), which are provided by health centers and smaller facilities throughout the country. However, while services have expanded, gaps in the quality of care remain.
Recognizing these gaps, the MoPH began a series of initiatives to improve quality in 2004, initiatives that also increased the number of partners working on health care in the country. In 2009, the MoPH began a new phase in its efforts to improve the quality of care. In order to improve coordination and complimentarity and help prioritize activities, it decided to establish a strategy for quality in health care that will provide a framework to focus MoPH, donor, and partner efforts to improve care for the Afghan people.
The Round Table Meeting provided an opportunity for two days of thoughtful conversation among members of the MoPH, partnering organizations, and a panel of experts. The purpose of the Round Table was to share relevant international health care improvement experiences with the MoPH so it can draw on them as it develops its national strategy and makes progress in improving the quality of health care services. Instead of the usual focus on prepared presentations, Dr. M. Rashad Massoud, HCI Director, designed the meeting as a forum for thoughtful dialogue in which both local and international expertise could be brought to bear in approaching Afghanistan’s unique issues of quality. The experiences shared by the panelists represented a wide range of diverse health care systems, including those in South Africa, Malaysia, Palestine, Sweden, the United Kingdom, Rwanda, and Tanzania. Topics discussed included vision and prioritization, defining quality, leadership to create and sustain a culture of quality, empowering local staff and communities, adapting processes to the local context, using data for decision making, learning and spread, involving stakeholders, setting standards, training and resources for health workers, the challenge of partner and donor coordination, and different approaches to quality.
The proceedings document summarizes the discussion and conclusions reached at the meeting for further consideration as the Ministry of Public Health moves forward in its development of a national strategy for health care quality.