SCA to implement Basic Health Package in Wardak province
Kabul 29 February 2004

On Thursday 26 February a contract for the Performance-based Partnership Agreement (PPA) for Wardak province was signed between the Swedish Committee for Afghanistan and the Ministry of Health. From 1 March SCA will take over responsibility for implementation of all health care in the province.
"I am very happy" says Jesper Frovin Jensen, Country Director of SCA, "to me this shows the confidence that both the Ministry and the World Bank have in SCA. We have a good performance record in Afghanistan over many years, and we are happy to be a part of the new development in health. As implementing partner for the Government's new health package in Wardak, I am confident we can improve the provision of health care in the province."

The Basic Package of Health Services (BPHS) was presented by the Afghan Ministry of Health in March 2003, as the result of a collaborative process between the Ministry and various donors, NGOs and UN agencies. It provides a standardized list of basic services which should form the core of all primary health care facilities and is designed to promote redistribution of services in order to improve access and benefit underserved areas.

The purpose of the Basic Package is to build a national health system in a country with one of the worst health records in the world. Maternal mortality rates in Afghanistan are particularly shocking, with approximately 1700 in 100 000 women dying due to complications during pregnancy and childbirth every year. In some remote parts of the country this figure is up to five times higher. One in four Afghan children dies before the age of five.

Since October 2003, SCA is implementing partner for the Ministry of Health in Kunduz province.

"With two entire provinces our organisation has taken on a sizeable challenge to help build a new health system. The BPHS focuses is on the health of individuals - an entire population. Our responsibilities no longer end at the gates of a clinic. This represents a much wider commitment", says Dr Ahmad Abd el Rahman, Senior Health Advisor of SCA.

He believes that lessons learned in Kunduz will benefit the work in Wardak. "Kunduz has demonstrated what it means to work in a partnership with local authorities. The experience also shows that the organisation needs to be flexible and fast-moving".

Still, Dr Ahmad emphasises that the actual provision of health care must differ from province to province, depending on the actual needs of the people. "The local situation will dictate requirements. Leishmanaiasis and leprosy are endemic diseases in some parts of Wardak. We cannot ignore this simply because it is not part of the BPHS. This would mean losing all credibility among the people".

To meet these needs he believes that SCA must cooperate with other actors and make use of their expertise. "We have discussed with Medair whether they can continue and expand their work in TB control. We also hope to work with WHO to combat child illnesses and other organisations like Health Net International who are very experienced in leishmanaiasis".

SCA has a strong presence in Wardak already, as facilitating partner for the Government's National Solidarity Programme, NSP. Dr Ahmad believes that the experience of working closely with local communities will be very useful when setting up new health services in the province.

SCA will take over the responsibility of health care in Wardak by 1 March 2004. The project is funded by the World Bank for 31 months.

For more information about SCA activities in Wardak, please contact:
Natasha Brieger, Information Coordinator; SCA
(Zarghona Maidan Street, opp Jamhoriat Hosp.) Kabul, Afghanistan
Email scainfocoord@brain.net.pk,
Phone: +93-(0)70-299 290