FOR IMMEDIATE RELEASE
February 23, 2006
Contact: Julie O'Brien
Phone: 617-250-9500
Email: jobrien@msh.org

Kabul, Afghanistan: With the formal adoption of the Essential Package of Hospital Services (EPHS), the Afghanistan Ministry of Public Health has provided the framework for Afghanistan's hospital system and defined the role of the country's district, provincial and regional hospitals. Now being distributed in English, Dari and Pushto, the EPHS provides the Afghan health sector with a clear delineation of the standardized package of hospital services to be supplied at each level of the health care system.

The EPHS marks the culmination of a process undertaken by the Ministry's Hospital Management Task Force in the fall of 2003 and brought to fruition through the technical help and financial support of USAID through the Rural Expansion of Afghanistan's Community-based Healthcare (REACH) Program, with additional input from other Ministry, NGO and international staff.

The EPHS is a crucial complement to the Basic Package of Health Services (BPHS), whose adoption by the Ministry of Public Health in March 2003 laid the foundation for Afghanistan's health care system. The BPHS, revised in 2005, specifies the most needed primary care services at the health post and health center levels of the health system. In keeping with the Ministry's goal of reducing high maternal and early childhood mortality rates, the BPHS also includes a hospital referral system for patients needing more specialized treatment and care.

Developing a framework for Afghanistan's hospital system and defining the role that hospitals will play at the district, provincial and regional levels—as well as the place to be occupied by tertiary and specialty hospitals in urban centers—has been critical to integrating the BPHS with the hospital system and assuring its success.

The EPHS classifies district, provincial and regional hospitals according to the size of the referral population, the number of beds, staff workload and complexity of patient services offered. Under the EPHS, hospitals at each of these levels will provide four core clinical functions: medicine, surgery, pediatrics, obstetrics and gynecology.

District hospitals will support the primary health services of the BPHS. Referrals will be made to provincial hospitals for more sophisticated diagnostic and treatment services, and, in turn, to regional hospitals for even more advanced care. Research and the training of medical officers, midwives and nurses will take place at all three hospital levels.

The EPHS also specifies for the MOPH, the private sector, NGOs and donors the type and number of staff and the facilities required at each hospital level, as well as the equipment, materials and drugs each hospital must have.

Hospitals utilize many of the most skilled workers in the Afghan health system and much of the available financial resources. To ensure effective and efficient use of scarce resources, in July 2004, REACH launched a $2 million Hospital Management Initiative to improve the quality of services and management practices in five provincial hospitals run by REACH NGO-grantees in Paktia, Paktika, Khost, Ghazni and Badakhshan provinces These five provincial hospitals are the first in Afghanistan to implement the full EPHS and are serving as models as the MOPH expands EPHS implementation throughout the country.

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