0
The Parliamentarians’ Perception of
the Public Health Sector in
Afghanistan
First Global Symposium on Health System Resear...
Overview
• Background
• Methodology
• Findings
• Recommendations
Background
• Who should set health sector priorities?
• Politicians views not systematically taken into
account
• Objectiv...
Methodology
• Questions
– to what extent the parliamentarians agree with
the selected priorities in the public health sect...
Data collection
• Public health department of Kabul Medical
University
• Data collected by medical students
• Almost one t...
Findings
Quality of health services improved
1.5
72.1
1.5
20.6
4.4 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
Amount of health services increased
4.4
63.2
5.9
22.1
4.4 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
Access to health services increased
1.5
63.61.5
28.8
4.6 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
People happy with public health services
1.5
23.5
8.8
58.8
7.4 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
Provincial officials are competent
1.5
41.8
11.9
34.3
10.5 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
People know what the MOPH is doing
1.5
21.5
16.9
53.9
6.2 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
MOPH provides enough information to
parliament
1.5
16.4
10.5
58.2
13.4 Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
MOPH successful in regulating private
pharmacies
1.5
10.5
10.5
47.8
29.9
Strongly Agree
Agree
DKN
Disagree
Strongly Disagr...
MOPH successful in regulating private
clinics
1.5
13.4
14.9
46.3
23.9
Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
MOPH successful in regulating private
hospitals
1.5
16.9
13.9
36.9
30.8
Strongly Agree
Agree
DKN
Disagree
Strongly Disagree
Top health problems
Child health problems 1
Maternal health problems 2
Mental health problems 3
Drugs 4
Tuberculosis 5
Mal...
29.4
25
19.1
26.5
Establish one of the Following
1 Hospital
3 Large Clinics
6 Medium Clinics
20 Small Clinics
What to do w...
MOPH focus
7.4
69.1
17.7
5.9
Rural Areas
Urban Areas
Both
DKN
36.8
1.5
60.3
1.5
Where it isWhere it should be
User fees
23.5
76.5
ClinicsYes
No
19
69.1
2.9
HospitalsYes
No
DKN
Continue working with NGOs
56.7
38.8
4.5
Yes
No
DKN
Reasons for low utilization
Reasons Ranking
Facilities too far 1
Low quality of services 2
Lack of female staff 3
Poor roa...
Ranking of sectors
Sectors Ranking
Security 1
Health 2
Education 3
Agriculture and irrigation 4
Transport including roads ...
Proportion of budget spent on health
Actually Spent Should be Spent
Median of responses 10% 19%
Recommendations
• Structured approach to incorporating
parliamentarians and communities
perspectives in policies, strategi...
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The Parliamentarians’ Perception of the Public Health Sector in Afghanistan

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Transcript of "The Parliamentarians’ Perception of the Public Health Sector in Afghanistan "

  1. 1. The Parliamentarians’ Perception of the Public Health Sector in Afghanistan First Global Symposium on Health System Research November 18, 2010
  2. 2. Overview • Background • Methodology • Findings • Recommendations
  3. 3. Background • Who should set health sector priorities? • Politicians views not systematically taken into account • Objectives: – To assess the parliamentarians’ perception regarding the public health sector – To measure and document political support
  4. 4. Methodology • Questions – to what extent the parliamentarians agree with the selected priorities in the public health sector – how the activities of the Ministry are perceived by parliamentarians – how important the health sector is compared to other sectors – what problems parliamentarians think people face in accessing health services • Random sampling
  5. 5. Data collection • Public health department of Kabul Medical University • Data collected by medical students • Almost one third of the parliamentarians took part in the survey • Funding from DelPHI
  6. 6. Findings
  7. 7. Quality of health services improved 1.5 72.1 1.5 20.6 4.4 Strongly Agree Agree DKN Disagree Strongly Disagree
  8. 8. Amount of health services increased 4.4 63.2 5.9 22.1 4.4 Strongly Agree Agree DKN Disagree Strongly Disagree
  9. 9. Access to health services increased 1.5 63.61.5 28.8 4.6 Strongly Agree Agree DKN Disagree Strongly Disagree
  10. 10. People happy with public health services 1.5 23.5 8.8 58.8 7.4 Strongly Agree Agree DKN Disagree Strongly Disagree
  11. 11. Provincial officials are competent 1.5 41.8 11.9 34.3 10.5 Strongly Agree Agree DKN Disagree Strongly Disagree
  12. 12. People know what the MOPH is doing 1.5 21.5 16.9 53.9 6.2 Strongly Agree Agree DKN Disagree Strongly Disagree
  13. 13. MOPH provides enough information to parliament 1.5 16.4 10.5 58.2 13.4 Strongly Agree Agree DKN Disagree Strongly Disagree
  14. 14. MOPH successful in regulating private pharmacies 1.5 10.5 10.5 47.8 29.9 Strongly Agree Agree DKN Disagree Strongly Disagree
  15. 15. MOPH successful in regulating private clinics 1.5 13.4 14.9 46.3 23.9 Strongly Agree Agree DKN Disagree Strongly Disagree
  16. 16. MOPH successful in regulating private hospitals 1.5 16.9 13.9 36.9 30.8 Strongly Agree Agree DKN Disagree Strongly Disagree
  17. 17. Top health problems Child health problems 1 Maternal health problems 2 Mental health problems 3 Drugs 4 Tuberculosis 5 Malaria 6 Diabetes 7 War related injuries 8 Cardiac disorders 9 Road accidents 10 Cancer 11 Disability 12 Eye problems 13 HIV/AIDS 14
  18. 18. 29.4 25 19.1 26.5 Establish one of the Following 1 Hospital 3 Large Clinics 6 Medium Clinics 20 Small Clinics What to do with limited fixed resources
  19. 19. MOPH focus 7.4 69.1 17.7 5.9 Rural Areas Urban Areas Both DKN 36.8 1.5 60.3 1.5 Where it isWhere it should be
  20. 20. User fees 23.5 76.5 ClinicsYes No 19 69.1 2.9 HospitalsYes No DKN
  21. 21. Continue working with NGOs 56.7 38.8 4.5 Yes No DKN
  22. 22. Reasons for low utilization Reasons Ranking Facilities too far 1 Low quality of services 2 Lack of female staff 3 Poor roads 4 Security problems 5 Lack of transport 6 Poor behavior of health workers 7 Cost of services 8 Cost of transport 9 Lack of knowledge 10 Family objection 11
  23. 23. Ranking of sectors Sectors Ranking Security 1 Health 2 Education 3 Agriculture and irrigation 4 Transport including roads 5 Administration reforms 6 Electricity/energy 7 Labor and public affairs 8 Housing 9 Industry 10
  24. 24. Proportion of budget spent on health Actually Spent Should be Spent Median of responses 10% 19%
  25. 25. Recommendations • Structured approach to incorporating parliamentarians and communities perspectives in policies, strategies and activities • Scope for building new alliances • Regular provision of information • Follow up surveys
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