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The development objectives of the System Enhancement for Health Action in Transition Project for Afghanistan are to expand the scope, quality and coverage of health services provided to the population, particularly to the poor, in the project areas, and to enhance the stewardship functions of the ministry of public health (MOPH). Financing is needed for implementation of the basic package of health services (BPHS) and essential package of hospital services (EPHS) through contracting out and contracting in arrangements both in rural and urban areas in provinces supported by the European union (EU), the Afghanistan Reconstruction Trust Fund (ARTF) and the World Bank, covering a total of twenty one provinces in the country (out of thirty four provinces). System enhancement for health action in transition (SEHAT) will be a platform nation-wide project, which will allow for financing health services in more provinces if additional resources become available. The project will also strengthen the national health system and ministry of public health's capacity at central and provincial levels, so it can effectively perform its stewardship functions in the sector.
SEHAT has three components which are i) Component 1: Sustaining and improving BPHS and EPHS services; ii) component II: Building the stewardship capacity of MoPH and system development and component III: Strengthening program management
For a decade, the European Union (EU), the United States Agency for International Development (USAID) and the World Bank (WB) have been supporting health service delivery in Afghanistan, each targeting a specific set of provinces. The World Bank provided financing for 11 provinces through Strengthening Health Activities for the Rural Poor (SHARP), which ended on September 30, 2013. Similarly, the EU provided financial support for the provision of Basic Package of Health Services (BPHS) and Essential Package of Hospital Services EPHS in 10 provinces, and USAID provides financing for the same service packages in the remaining 13 provinces. The support has been well coordinated by the Ministry of Public Health (MoPH) and the package of services provided was very similar in each of the provinces. Central functions were also supported by these three development partners in a complementary fashion. Under this arrangement, the WB supported a Service Procurement and Contract Management Department (SPCMD/ GCMU), third party monitoring and results based financing for improved service delivery. Besides financing BPHS and EPHS, EU and the USAID also financed SPCMD and capacity building activities both for the MOPH and the NGOs. The bilateral EU support to the Basic Package of Health Services (BPHS) and the Essential Package of Hospital Services (EPHS) finished on December 30, 2013.
The SEHAT Project finances the implementation of the BPHS and EPHS through contracting out and contracting in arrangements both in rural and urban areas in provinces supported by the EU, the ARTF and the World Bank, covering 21 of the 34 provinces in the country and urban Kabul. With the USAID joining SEHAT, it will be a platform nation-wide project that allows for financing health services in all 34 provinces of the country. In addition, financial support for implementation of Results-Based Financing will continue under SEHAT project through June 30, 2018.
The project will also strengthen the national health system and MOPH’s capacity at central and provincial levels. In an effort to effectively perform its stewardship function the MoPH in collaboration with the development partners identified ten thematic areas to be supported under SEHAT. The groups, assigned to develop thematic areas proposals, have already started their work and the progress to date is slow as it is a new experience for the MoPH departments.
Download the SEHAT EPP (Emergency Project Paper) here