BRAC Afghanistan Health Programme

BRAC Afghanistan's health interventions are launched just after its registration with the Government of Afghanistan in June 2002. Initially BRAC Afghanistan started community based health care programme aiming to improve the health status of Afghans particularly to the rural poor. The Ministry of Public Health (MoPH) of Islamic Republic of Afghanistan introduced the Basic Package of Health Services (BPHS) in 2003. The BPHS was developed based on the priority issues for the health sector and with aim of improving access of population to the minimum basic health care services. The MoPH is following the contracting out policy and playing stewardship role for the implementation of BPHS, and the performance of the NGO is assessed through third party evaluation.

BRAC Afghanistan become one of the active implementing partner of MoPH in the implementation of BPHS in Balkh, Badghis, Kabul and Nimroz provinces funded by the World Bank and USAID-REACH.

BRAC Afghanistan is also the Principal Recipient (PR) for Tuberculosis and Malaria control programme of the Global Fund Round 8. BRAC Afghanistan health programme is implementing TB control programme in countries 34 provinces.

Major donors of BRAC Afghanistan Health Programme are; The World Bank, Oxfam Novib, USAID, The Global Fund, The Union, Spanish PRT (AECI) and Gavi.

Various Health Projects of BRAC Afghanistan

Performance Based Partnership Agreements (PPA):
This programme is implemented in three provinces i.e. Balkh , Badghis and Nimroz. These projects cover the entire provinces in terms of delivery of health care services. It is financially supported by MoPH/World Bank and and has agreed to extend these projects upto end of June 2009. The overall objectives of the PPA is to ensure quality BPHS for the catchments area of health facilities and health posts. This is a contract-out project and the implementers are bound to achieve certain targets. Every year third party evaluation will take place to evaluate the progress and the NGO with certain performance will be awarded a bonus.

Community Based Health Care Project (CBHP):
This project is implemented in eight districts of two provinces i.e. Parwan and Nangahar with financial support of Oxfam Novib. The primary objectives of the CBHP is to deliver quality health care services at the community level. Initially, this project was for the three years from January 2005 to December 2007 then it was extended for 10 months (upto October 2008) and currently the project has extended for another three years which started from November 2008.

Community Midwifery Education (CME):
This program is implemented in Badghis province. First batch of 14 Community midwifes were graduated in October 2006, and the second batch training of 19 students was completed course in March 2009.

BRAC Afghanistan has also been awarded CME project in Nimroz province and the programme will start in middle 2009. The objective of the CME is to build capacities of the community midwifes in order to reduce maternal, neonatal and child mortalities. The training of second batch is financially supported by Spanish Agency for International Cooperation (AECI) in Badghis province.and in Nimroz provinces, is financially supported by GAVI/HSS through the Ministry of Public Health.

Behavioral Change Communication (BCC) Project:
This is a one year pilot project financially supported by UNICEF in 6 different districts under six provinces in Afghanistan . BRAC Afghanistan is implementing this project only in Surkhrod district of Nangahar province and in other districts it is implemented by other NGOs. The objective of this project is to improve health status of the population particularly maternal and child health through active participation of the community people.

Mobile Health Team
This is a GAVI/MoPH funded project through Ministry of Public Health. The duration of Mobile Health Team projects is 40 months. This project will be implemented in Nimroz and Badghis provinces. This is an innovative strategy to ensure health for all, particularly for women and children living in inaccessible parts of the country.

Global Fund Round 8
BRAC Afghanistan has been selected as Principal Recipient (PR) for both Malaria and TB components of Global Fund Round 8. BRAC Afghanistan will be CO-PR with MoPH for TB component and Health Net TPO and MoPH for Malaria component.

Tuberculosis Control Program:
Initially BRAC started Community based DOTS in 2004 in two districts, one in each of the Parwan and Balkh provinces. Following the introduction of BPHS by Government of Afghanistan, BRAC established TB services in all its health facilities. Moreover, BRAC has enhanced its TB control program with the support of International Union Against Tuberculosis and Lung Diseases “The Union” since January 2006.

Currently BRAC Afghanistan provides TB control services through 92 treatment and diagnostic centres and 57 treatment centres in 7 provinces of Afghanistan Besides Intregrated TB programme with BPHS, BRAC Afghanistan is implementing the following community based TB projects in Afghanistan.

FIDELIS Project
BRAC Afghanistan initiated community based TB DOTS through FIDELIS project in Afghanistan in 2006. BRAC has expanded TB diagnostic facilities through establishing 50 TB microscopy centres at different levels of health care setting from the 1st phase of FIDELIS programme (January 2006~ March 2007). Another 92 TB microscopy will be established over the current phase of FIDELIS programme (July 2008~ December 2009).Because of implementation of CB-DOTS, BRAC Afghanistan has received several appreciation certificates from the Ministry of Public Health, National Tuberculosis Control Programme and Provincial Governor. And after successful completion of the first phase of FIDELIS project, The Union requested BRAC Afghanistan to prepare an action plan and budget for extension of the project for next three years.

TB CAP Project
TB control assistance programme (TB CAP) is a project supported by USAID through MSH in Afghanistan. The objective of the project is to improve the TB control programme in Afghanistan. The project is implemented in a partnership of BRAC Afghanistan, MSH and WHO. BRAC Afghanistan will be implemented the community based DOTS component of the project through replicating the community based DOTS model introduced through FIDELIS project. This is a one year project and BRAC Afghanistan will support the BPHS implementers in 4 provinces i.e Badakshan, Baghlan, Jawzjan and Herat provinces to implement the community based DOTS through their existing health system.

BRAC Health Program At a glance (as of December, 2009)