ARTF – Sehatmandi

OVERVIEW

Sehatmandi is a three-year, $600 million on-budget project administered by the World Bank through the Afghanistan Reconstruction Trust Fund (ARTF) and implemented by the Afghanistan Ministry of Public Health. The project objective is to increase the utilization and quality of health, nutrition, and family planning services. USAID contributes $90 million; other major donors include the World Bank, European Union, Canada, and Global Financing Facilities.

Sehatmandi supports delivery of Afghanistan’s Basic Package of Health Services and Essential Package of Hospital Services across all 34 provinces with a focus on improving performance of health services by introducing pay for performance initiatives. Sehatmandi supports the Ministry of Public Health guidelines for the Basic Package of Health Services and Essential Package of Hospital Services primarily by issuing contracts to national and international non-governmental organizations.

ACTIVITIES

COMPONENT 1: IMPROVING HEALTH SERVICE DELIVERY ($570 MILLION)

• Strengthening the Basic Package of Health Services and Essential Package of Hospital Services by improving the efficiency and equity of contracting through lump sum contracts, greater contracting flexibility, encouraging innovation, and expanding primary health centers

COMPONENT 2: STRENGTHENING THE HEALTH SYSTEM ($20 MILLION)

• Reform management and governance of regional and tertiary hospitals, focusing on hospital performance, the use of clear, results-based contracts, and exploring new partnerships with the private sector

COMPONENT 3: STRENGTHENING COMMUNITY ENGAGEMENT ($10 MILLION)

• Strengthen accountability of health facilities by using community scorecards and implementing grievance redress mechanisms established under the Afghan Citizen's Charter, an initiative to improve the relationship between the government and its people by providing basic public services

ACCOMPLISHMENTS

• In June 2019, conducted first Sehatmandi quarterly performance review
• Developed standard operating procedures for managing pay for performance initiatives to improve health services
• Ministry of Public Health established new Office of Performance Management for Sehatmandi project and recruited most personnel
• Completed procurement to contract services through NGOs
• As of September 2018, over 2,700 health faculties were operational throughout the country, providing primary and secondary health services
• Ensured that 95 percent of all public health facilities have at least one female health service provider
• Administered PENTA3 vaccine to 59 percent of children 12 – 23 months of age
• Treated 77 percent of children under the age of five with severe acute malnutrition
• Skilled doctors, nurses, and midwives attended 910,165 deliveries in fiscal year 2018
• Ninety percent of population has access within two hours to health facility