Government stewardship of the for-profit private health sector in Afghanistan

Bibliographic Data

ID11490226
AuthorsHarry E Cro (0000-0002-2673-6847, Futures Group (United States), corresponding author), Harry E Cross, Omarzaman Sayedi (Futures Group (United States)), Laili Irani (0000-0002-5472-507X, Population Reference Bureau), Lauren C Archer (Futures Group (United States)), Kathleen Sears (Futures Group (United States)), Suneeta Sharma (Futures Group (United States))
Year2016
Volume32
Issue3
Pagesczw130
Publication date2016-09-28
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czw130
PMID27683341
OpenAlexW2526564438
LanguageEN
Citations received5
References cited7

BACKGROUND: Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. AIM: We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. METHODS: We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. RESULTS: The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. CONCLUSIONS: The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a more efficient and effective for-profit private sector. These successful early efforts offer high-leverage potential to rapidly scale up going forward.

Accountability · Business · Corporate governance · Economic growth · Economics · Environmental resource management · Government (linguistics) · Political science · Private sector · Public sector · Stewardship (theology) · Transparency (behavior) · Finance · Global Maternal and Child Health · Healthcare Systems and Reforms · Legal, Health, Environmental and COVID-19 Challenges

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