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The Parliamentarians’ Perception of the Public Health Sector in Afghanistan
- 1. The Parliamentarians’ Perceptionof the Public Health Sector in Afghanistan First Global Symposium on Health System Research November 18, 2010
- 2. Overview • Background • Methodology •Findings • Recommendations
- 3. Background • Who shouldset 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. Methodology • Questions – towhat 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. Data collection • Publichealth 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.
- 7. Quality of healthservices improved 1.5 72.1 1.5 20.6 4.4 Strongly Agree Agree DKN Disagree Strongly Disagree
- 8. Amount of healthservices increased 4.4 63.2 5.9 22.1 4.4 Strongly Agree Agree DKN Disagree Strongly Disagree
- 9. Access to healthservices increased 1.5 63.61.5 28.8 4.6 Strongly Agree Agree DKN Disagree Strongly Disagree
- 10. People happy withpublic health services 1.5 23.5 8.8 58.8 7.4 Strongly Agree Agree DKN Disagree Strongly Disagree
- 11. Provincial officials arecompetent 1.5 41.8 11.9 34.3 10.5 Strongly Agree Agree DKN Disagree Strongly Disagree
- 12. People know whatthe MOPH is doing 1.5 21.5 16.9 53.9 6.2 Strongly Agree Agree DKN Disagree Strongly Disagree
- 13. MOPH provides enoughinformation to parliament 1.5 16.4 10.5 58.2 13.4 Strongly Agree Agree DKN Disagree Strongly Disagree
- 14. MOPH successful inregulating private pharmacies 1.5 10.5 10.5 47.8 29.9 Strongly Agree Agree DKN Disagree Strongly Disagree
- 15. MOPH successful inregulating private clinics 1.5 13.4 14.9 46.3 23.9 Strongly Agree Agree DKN Disagree Strongly Disagree
- 16. MOPH successful inregulating private hospitals 1.5 16.9 13.9 36.9 30.8 Strongly Agree Agree DKN Disagree Strongly Disagree
- 17. Top health problems Childhealth 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. 29.4 25 19.1 26.5 Establish one ofthe Following 1 Hospital 3 Large Clinics 6 Medium Clinics 20 Small Clinics What to do with limited fixed resources
- 19. MOPH focus 7.4 69.1 17.7 5.9 Rural Areas UrbanAreas Both DKN 36.8 1.5 60.3 1.5 Where it isWhere it should be
- 20.
- 21. Continue working withNGOs 56.7 38.8 4.5 Yes No DKN
- 22. Reasons for lowutilization 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. Ranking of sectors SectorsRanking 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. Proportion of budgetspent on health Actually Spent Should be Spent Median of responses 10% 19%
- 25. Recommendations • Structured approachto incorporating parliamentarians and communities perspectives in policies, strategies and activities • Scope for building new alliances • Regular provision of information • Follow up surveys