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Comprehensive Approach to Building Afghanistan Health Economics & Finance Directorate

Comprehensive Approach to Building Afghanistan Health Economics & Finance Directorate. Better Health Systems: Strategies that Work Presentation Series at the Global Health Council Ibrahim Shehata February 7, 2012. Summary . Challenges Planning comprehensive approach

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Comprehensive Approach to Building Afghanistan Health Economics & Finance Directorate

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  1. Comprehensive Approach to Building Afghanistan Health Economics & Finance Directorate Better Health Systems: Strategies that Work Presentation Series at the Global Health Council Ibrahim Shehata February 7, 2012

  2. Summary • Challenges • Planning comprehensive approach • Transitioning to self-sustaining health systems

  3. Challenges • Dependence on donor funding (85%) and no tax base for revenue generation • High level of OOP (75%) • Limited capacity in budget execution (60%) • Low public per capita expenditure (4%) • Low capacity in applied health economics and resource management

  4. Planning for Comprehensive Approach • Develop a comprehensive health financing strategy that emphasizes: • Mobilizing Afghan human resources • Gradual decrease on donor dependency • Aid coordination • Sustainability

  5. Mobilize Local Resources • Build and institutionalize the technical capacity of HEFD staff: • Enrolled 7 HEFD staff in master’s degree program in health economics • On-the-job training programs provided to HEFD staff • HEFD organizational and operational improvements

  6. Gradual Decrease on Donor Dependency • Develop revenue generation policy that introduces “sin taxes” on interventions having negative externalities on health • Support MOPH advocacy efforts • Evaluate user fees • Improve budget execution to 100%

  7. Improve Aid Coordination • Coordinate technical support with WB, EC, and other USAID projects • Expenditure management information system • Health financing policy • Costing BPHS, EPHS, and vertical programs

  8. Ensure Sustainability • Implement the most comprehensive public program to transition donor funded civil servant employees into the Afghan “tashkeel” (civil service system) • Cost tashkeel positions • Identifying staffing capacity needs currently missing in the tashkeel • Both take stock of and cost the training, which will enable “topped up” staffing positions to effectively and efficiently perform their functions • Increasing competitiveness of tashkeel salaries • Develop an action plan and timeline for the MoPH to implement changes • Design a five-year performance-assessment-monitoring and evaluation process and reporting framework

  9. Reflection • In some ways, it is easier to impact health systems in post-conflict countries because often you are designing the system from scratch without having to navigate the existing system and its bureaucracy

  10. Thank you www.HealthSystems2020.org

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