Afghanistan: Primary Health Care Partnership for the Poor (formerly Piloting Health Care Partnership)

Sovereign Project | 36628-012 Status: Closed

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Project Name Primary Health Care Partnership for the Poor (formerly Piloting Health Care Partnership)
Project Number 36628-012
Country Afghanistan
Project Status Closed
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 9030-AFG: Primary Health Care Partnership for the Poor (formerly Piloting Health Care Partnership)
Japan Fund for Poverty Reduction US$ 3.00 million
Strategic Agendas Environmentally sustainable growth
Inclusive economic growth
Drivers of Change
Sector / Subsector

Health - Health sector development and reform

Gender Equity and Mainstreaming Gender equity
Description The Project will explore potential partnership of MoPH, NGOs and communities to develop sustainable community-based primary health care in poor rural communities currently not having Government or NGO services, as a pilot for replication nationwide. The objective is to substantially reduce maternal and child mortality, prevalence of infectious diseases, malnutrition, and fertility (targets will be set later) in these targeted communities over a three-year period. The Project will improve access to basic health, nutrition and birth spacing interventions, provide quality care at low cost, and promote healthy life style. The Project will generate local contract labor. The Project will reach about 10 districts total, in Badakhshan, Bamyan, Kapisa, Samangan and Uruzgan provinces.
Project Rationale and Linkage to Country/Regional Strategy

The overall objectives of the Projects were to: (i) reduce Infant Mortality Rate (IMR) by 30%, the prevalence of common infectious diseases and malnutrition in children, the maternal mortality ratio, and the birth rate in the targeted communities over a period of 3 years; (ii) demonstrate the potential of partnership of the Ministry of Health (MOH), and NGOs, and communities in developing sustainable community-based health service delivery system, targeting 10 high priority districts, which lacked services, for a possible replication of the system nationwide ((later reduced to 9 districts: 5 in Badakhdhan Province and 4 in Gohr District).

The specific objective of the Project are to (i) make interventions through health centers and with the use of CHWs; (ii) provide quality health services at less cost by training health staff of MOH and CHWs, supplying equipment , and developing a drug supply system; (iii) improve water supply and sanitation through the provision and repair of water pumps and latrines, including schools; (v) promote healthy life styles and timely referral through health, nutrition , and birth spacing education, by increasing access to radio education programs for women and by training local leaders, CHWs, and health staff; (vi) strengthen local leadership in community development activities for health, with linkages to other sectors such as education and agriculture, and (vii) build the capacity of MOH, NGO, and communities in a sustainable partnership.

The Project consisted of five components: (i) support to local community organization and NGOs ($693,000); (ii) support to local health centers construction and rehabilitation ($670,000); (iii) training and capacity development of CHWs ($542,000); (iv) essential drug supply ($471,000); and (v) project management ($220,000).


1. Reduce poverty by improving health, nutrition, and reproductive health status of the rural poor.

2. Demonstrate the potential of Ministry of Health (MOH)-nongovernment organization (NGO) partnership to develop quality community-based health care for the poor in 10 undeserved districts.

Project Outcome
Description of Outcome

1. Improvement of health services in 10 districts.

2. Community Health Worker (CHW) program for women and children.

3. Drug supply system.

4. Capacity building in public-private partnership.

Progress Toward Outcome
Implementation Progress
Description of Project Outputs

1. Community Management.

2. Health centers.

3. CHW services

4. Drug supply system

5. MOH capable of contracting and managing NGOs.

Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design Participatory planning important in preparing project implementation manual
During Project Implementation

The Project's design, objectives, components, implementation arrangements and schedule were appropriate and relevant in view of the fast evolving context of Afghanistan, with the limited government capacity and NGOs' strong presence at the community level.

All stakeholders actively participated in the Project's activities from the planning stage and then throughout the entire project implementation period. MOH and the Ministry of Finance made good communications for project implementation on a regular basis. Many collaborating international and local NGOs also demonstrated their strong interest in the Project, and provided their advice and supports to the Project, which had to be implemented despite a substantial difficulty in terms of geography, climatic condition, capacity of governments, security, and cultural aspects.

Communities, the most important stakeholders, were fully involved in the Project at each stage of project implementation. They always extended their contribution to the Project, in terms of provision of labor and donation of land for clinic buildings, ensuring security of clinic staff, and introducing volunteers who became CHWs. Women Committees were also organized and they regularly held meetings for decision making on the health-related matters in their communities. The local authorities of MOH were also cooperative and they fully participated in project implementation. The Project also received technical support from local health authorities of the Government of Tajikistan. (For example, female health workers had to be brought and recruited from Tajikistan.) Furthermore, the Project received technical support of UNICEF, WHO and other international development agencies in Afghanistan.

Business Opportunities
Consulting Services A total of 12 person-months of domestic consulting services will be required for project management, NGO contracting, participatory planning and community development, engineering, and community-based drug supply.
Responsible ADB Officer Michiel Van der Auwera
Responsible ADB Department Central and West Asia Department
Responsible ADB Division Public Management, Financial Sector and Trade Division, CWRD
Executing Agencies
Dr. Ferouzudeen Ferouz, Deputy Minister
Concept Clearance 11 Mar 2002
Fact Finding 16 Mar 2002 to 21 Mar 2002
Approval 19 Dec 2002
Last Review Mission -
Last PDS Update 01 Sep 2011

Grant 9030-AFG

Approval Signing Date Effectivity Date Closing
Original Revised Actual
19 Dec 2002 15 May 2003 15 May 2003 31 Dec 2003 31 May 2007 20 Nov 2011
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 3.00 Cumulative Contract Awards
ADB 0.00 19 Dec 2002 0.00 2.81 94%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 3.00 19 Dec 2002 0.00 2.81 94%
Title Document Type Document Date
Primary Health Care Partnership for the Poor Grant Assistance Reports Dec 2002

Safeguard Documents

See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

None currently available.

Evaluation Documents

See also: Independent Evaluation

None currently available.

Related Publications

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